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FREDERCIK CHIABING CHUO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
401 S MAIN ST, STE B5, ALPHARETTA, GA 30004-1974
(770) 663-8717
Mailing address
217 MAIN ST, DESTIN, FL 32541-2503
(850) 837-7448
(850) 837-2042

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
013110
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143808112A
GA
Enumeration date
11/09/2006
Last updated
07/08/2007
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