Provider Demographics
NPI:1053719427
Name:CHO, TOM (DDS)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5708 UPTAIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5615
Mailing Address - Country:US
Mailing Address - Phone:423-894-3553
Mailing Address - Fax:423-499-1938
Practice Address - Street 1:5708 UPTAIN RD STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5615
Practice Address - Country:US
Practice Address - Phone:423-894-3553
Practice Address - Fax:423-499-1938
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000010020122300000X
TN11774122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist