Provider Demographics
NPI:1558897686
Name:BORTH, CHANDLER CHOATE (DDS)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:CHOATE
Last Name:BORTH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHANDLER
Other - Middle Name:DAWN
Other - Last Name:CHOATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8305 WALNUT HILL LN STE 225
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4259
Mailing Address - Country:US
Mailing Address - Phone:214-361-5437
Mailing Address - Fax:
Practice Address - Street 1:8305 WALNUT HILL LN STE 225
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4259
Practice Address - Country:US
Practice Address - Phone:214-361-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry