Provider Demographics
NPI:1588359764
Name:PRATIMA CHANDLER DDS PLLC
Entity type:Organization
Organization Name:PRATIMA CHANDLER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PRATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:484-751-8483
Mailing Address - Street 1:124 IVY HILLS TER
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-6144
Mailing Address - Country:US
Mailing Address - Phone:484-751-8483
Mailing Address - Fax:
Practice Address - Street 1:37 MADDEX DR
Practice Address - Street 2:
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-4322
Practice Address - Country:US
Practice Address - Phone:484-751-4843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty