Most Relevant Information
Provider Data
| NPI Number: | 1003003781 |
| Provider Name: | SUPAK CHOTI DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 56408 |
Most Important Dates
| Enumeration Date: | 09/26/2007 |
| Last Updated: | 12/04/2012 |
Provider Practice Location
38096 HIGHWAY 299 E
BURNEY
CA
960139792
Practice Location Phone/Fax
| Phone: | 5304105851 |
| Fax: |
Provider Mailing Location
3671 FOOTHILL BLVD
REDDING
CA
960010616
Provider Mailing Phone/Fax
| Phone: | 5305103077 |
| Fax: |