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NPI Code Detail

MEDICARE: KIM M CHAU DMD

MEDICARE: KIM M CHAU DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist18835MA

General Provider Information

NPI Number : 1114904117
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM M CHAU DMD
Provider Business Mailing Address
First Line : 111 BOSTON POST RD
Second Line : SUITE 104
City : SUDBURY
State : MA
Zip : 01776-2463
Country : US
Telephone Number : 978-440-8177
Fax Number : 978-440-8175
Provider Business Practice Location Address
First Line : 111 BOSTON POST RD
Second Line : SUITE 104
City : SUDBURY
State : MA
Zip : 01776-2463
Country : US
Telephone Number : 978-440-8177
Fax Number : 978-440-8175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 07/08/2007

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Directions to “ KIM M CHAU DMD” Practice Location

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