Provider Demographics
NPI:1104418896
Name:CHO, FORMICA, LOVE & ASSOCIATES, P.A.
Entity type:Organization
Organization Name:CHO, FORMICA, LOVE & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-262-3535
Mailing Address - Street 1:3233 SUPERIOR LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1920
Mailing Address - Country:US
Mailing Address - Phone:301-262-3535
Mailing Address - Fax:301-464-3478
Practice Address - Street 1:3233 SUPERIOR LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1920
Practice Address - Country:US
Practice Address - Phone:301-262-3535
Practice Address - Fax:301-464-3478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1285040998OtherNPI
MD1528334034OtherNPI
MD1457627838OtherNPI