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NPI Code Detail

MEDICARE: CENTRAL VALLEY DENTISTRY

MEDICARE: CENTRAL VALLEY DENTISTRY
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
11223G0001XGeneral Practice DentistryD008264AZ

General Provider Information

NPI Number : 1265773782
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL VALLEY DENTISTRY
Provider Business Mailing Address
First Line : 6232 N 7TH ST
Second Line : SUITE 201
City : PHOENIX
State : AZ
Zip : 85014-1839
Country : US
Telephone Number : 602-246-0385
Fax Number : 602-393-1023
Provider Business Practice Location Address
First Line : 6232 N 7TH ST
Second Line : SUITE 201
City : PHOENIX
State : AZ
Zip : 85014-1839
Country : US
Telephone Number : 602-246-0385
Fax Number : 602-393-1023
Authorized Official
Title or Position : OWNER
Name : DR. JAE Y CHO
Credential : DMD
Telephone Number : 602-246-0385
Provider Enumeration Date : 03/07/2013
Last Update Date : 03/07/2013

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Directions to “CENTRAL VALLEY DENTISTRY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.