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General NPI Number Information
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NPI Number | 1912096215
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Entity Type | Organization
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Legal Business Name | J.THOMAS CHESS,DDS,INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 COLUMBIA ST
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-1652
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Country | US
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Telephone | 323-682-1133
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Fax | 323-682-1284
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Provider Business Mailing Address
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Address Line | 500 COLUMBIA ST
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-1652
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Country | US
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Telephone | 323-682-1133
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Fax | 323-682-1284
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Authorized Official
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Title or Position | PRESIDENT-OWNER
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Name | DR. JOSEPH THOMAS CHESS
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Credential | D.D.S.
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Telephone | 323-682-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 17658
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License Number State | CA
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