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General NPI Number Information
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NPI Number | 1417096306
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Entity Type | Individual
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Provider Name | DICK CHOPRA D.D.S
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 235 W WESTERN AVE STE 7
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City | AVONDALE
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State | AZ
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Zip | 85323-1848
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Country | US
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Telephone | 623-925-1426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 734
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-0734
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Country | US
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Telephone | 602-315-7135
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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 | 4724
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License Number State | AZ
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