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General NPI Number Information
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NPI Number | 1568798726
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Entity Type | Organization
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Legal Business Name | MATTHEW K CHOW DDS PA
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 401 CLINTON PKWY
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City | CLINTON
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State | MS
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Zip | 39056-4011
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Country | US
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Telephone | 601-924-8478
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Fax | 601-925-1473
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Provider Business Mailing Address
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Address Line | 401 CLINTON PKWY
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City | CLINTON
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State | MS
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Zip | 39056-4011
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Country | US
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Telephone | 601-924-8478
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Fax | 601-925-1473
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW KING CHOW
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Credential | DDS
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Telephone | 601-924-8478
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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 | 3525-09
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License Number State | MS
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