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Individual
WAYNE S CHANLER
Active
Individual
WAYNE S CHANLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD,PC
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
032121
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00464291
—
NY
01
—
32121
CSEA
NY
01
—
5828183
AETNA
NY
01
—
7710
BLUE CROSS
NY
Enumeration date
03/15/2007
Last updated
07/09/2007
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