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General NPI Number Information
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NPI Number | 1528794765
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Entity Type | Individual
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Provider Name | YOO JIN CHA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 820 N VAN BUREN AVE
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City | MT PLEASANT
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State | TX
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Zip | 75455-3250
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Country | US
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Telephone | 903-572-5635
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Fax |
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Provider Business Mailing Address
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Address Line | 205 CREEKSIDE DR
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City | MURPHY
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State | TX
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Zip | 75094-4328
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Country | US
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Telephone |
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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 | 38844
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License Number State | TX
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