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Organization
A. TINA CHANDRA, D.D.S., P.A.
Active
Organization
A. TINA CHANDRA, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE M CUSTER (OFFICE ADMINISTRATOR)
(352) 861-1500
Entity
Organization
Contact information
Practice address
1920 SW 20TH PL, SUITE 202, OCALA, FL 34471-7881
(352) 861-1500
(352) 861-1507
Mailing address
1920 SW 20TH PL, SUITE 202, OCALA, FL 34471-7881
(352) 861-1500
(352) 861-1507
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN14503
FL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174669485
NATIONAL PROVIDER IDENTIFICATION
FL
Enumeration date
03/21/2014
Last updated
10/24/2018
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