Provider Demographics
NPI:1427665751
Name:CHANDAN DENTAL ASSOCIATES
Entity type:Organization
Organization Name:CHANDAN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVESHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-376-7161
Mailing Address - Street 1:3242 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SANDY LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:16145
Mailing Address - Country:US
Mailing Address - Phone:724-376-7161
Mailing Address - Fax:
Practice Address - Street 1:3242 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:SANDY LAKE
Practice Address - State:PA
Practice Address - Zip Code:16145
Practice Address - Country:US
Practice Address - Phone:724-376-7161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental