Healthcare Provider Details

I. General information

NPI: 1295867257
Provider Name (Legal Business Name): JOHN LEE CHIOU D.M.D, M.M.SC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOHNNY LEE CHIOU D.M.D, M.M.SC

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 06/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 WASHINGTON RD.
RYE NH
03870-5431
US

IV. Provider business mailing address

475 WASHINGTON RD
RYE NH
03870-2459
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-5646
  • Fax:
Mailing address:
  • Phone: 603-436-5646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number3579
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: