Provider Demographics
NPI:1396977369
Name:CHAUDHARY, SANJEET R (DMD)
Entity type:Individual
Prefix:
First Name:SANJEET
Middle Name:R
Last Name:CHAUDHARY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 POST OAK TRITT RD STE 500
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8609
Mailing Address - Country:US
Mailing Address - Phone:770-973-1738
Mailing Address - Fax:770-971-9407
Practice Address - Street 1:2155 POST OAK TRITT ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:770-973-1738
Practice Address - Fax:770-971-9407
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery