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General NPI Number Information
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NPI Number | 1336767888
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Entity Type | Individual
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Provider Name | AIRY CHOI DMD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2020
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 5710 WATAUGA RD
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City | WATAUGA
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State | TX
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Zip | 76148-3022
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Country | US
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Telephone | 817-281-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 GAGE AVE APT 225
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City | FORT WORTH
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State | TX
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Zip | 76109-1588
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Country | US
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Telephone | 504-261-9755
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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 | 36331
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License Number State | TX
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