Provider Demographics
NPI:1992764666
Name:CHOW, JEFFREY C H (DDS, MBA)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C H
Last Name:CHOW
Suffix:
Gender:M
Credentials:DDS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 E GUADALUPE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5116
Mailing Address - Country:US
Mailing Address - Phone:480-635-8787
Mailing Address - Fax:480-635-8787
Practice Address - Street 1:2450 E GUADALUPE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5116
Practice Address - Country:US
Practice Address - Phone:480-635-8787
Practice Address - Fax:480-635-8787
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD55811223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics