Individual
DR. ROBERT CHUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
2140 16TH ST N, ST PETERSBURG, FL 33704-3924
(727) 894-1442
(727) 823-0466
Mailing address
2140 16TH ST N, ST PETERSBURG, FL 33704-3924
(727) 894-1442
(727) 823-0466
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN10893
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME0046866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072216200
—
FL
01
—
84866
BLUE CROSS
FL
Enumeration date
07/12/2005
Last updated
12/09/2011
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