Choti, Supak
Choti, Supak is an individual health care provider with primary practice located at 38096 Highway 299 E , Burney CA 96013-9792. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Choti, Supak can be contacted via phone (530) 410-5851.Contact Information
Primary practice address
38096 Highway 299 E
Burney CA 96013-9792
Phone: (530) 410-5851
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 56408 | California |
Profile Details
| NPI number | 1003003781 |
|---|---|
| LBN Legal business name | Choti, Supak |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2007 |
| Last updated | Dec 4th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003003781 | NPPES |
| California | MEDICAID | 56408 |
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