Individual
DAVID CHODOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2200 GRANDE BLVD SE STE A, RIO RANCHO, NM 87124
(505) 891-1500
Mailing address
715 MOUNTAIN RD NW, ALBUQUERQUE, NM 87102-2070
(203) 536-0508
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4690
NM
1223G0001X
General Practice Dentistry
DD4690
NM
Other
Enumeration date
02/20/2017
Last updated
07/17/2018
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