MEDICARE: KUAN- YU CHO DDS

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
1	1223G0001X	General Practice Dentistry	4590	NV

General Provider Information

NPI Number	:	1457440810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUAN- YU CHO DDS

Provider Business Mailing Address
First Line	:	2243 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2979
Country	:	US
Telephone Number	:	702-365-0100
Fax Number	:	702-365-0200

Provider Business Practice Location Address
First Line	:	2243 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2979
Country	:	US
Telephone Number	:	702-365-0100
Fax Number	:	702-365-0200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	06/24/2008

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