Provider Demographics
NPI:1124158563
Name:CZOCHANSKI, JOHN THOMAS (DDS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:THOMAS
Last Name:CZOCHANSKI
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 1:2606 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869
Mailing Address - Country:US
Mailing Address - Phone:714-639-6181
Mailing Address - Fax:714-639-6182
Practice Address - Street 1:2606 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869
Practice Address - Country:US
Practice Address - Phone:714-639-6181
Practice Address - Fax:714-639-6182
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA369091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice