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General NPI Number Information
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NPI Number | 1275103822
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Entity Type | Individual
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Provider Name | SAMUEL CHO JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2021
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Last Update Date | 06/27/2021
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Provider Practice Location Address
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Address Line | 620 M ST NE
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City | AUBURN
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State | WA
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Zip | 98002-4501
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Country | US
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Telephone | 425-420-7747
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Fax |
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Provider Business Mailing Address
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Address Line | 6717 ROOSEVELT WAY NE APT 107
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City | SEATTLE
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State | WA
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Zip | 98115-6681
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Country | US
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Telephone | 425-420-7747
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DE61179257
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License Number State | WA
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