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General NPI Number Information
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NPI Number | 1063863322
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Entity Type | Individual
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Provider Name | CHAU MCGOVERN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 15761 SHERIDAN ST STE A
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33331-3486
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Country | US
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Telephone | 954-799-6212
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Fax | 954-250-6520
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Provider Business Mailing Address
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Address Line | 7676 EAGLE POINT DR
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City | DELRAY BEACH
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State | FL
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Zip | 33446-3483
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Country | US
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Telephone | 954-464-6956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21989
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN21989
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License Number State | FL
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