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Individual

DR. RAVI CHANDRAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD PHD

Contact information

Practice address
4915 LAVISTA RD, TUCKER, GA 30084-8520
(770) 934-1907
(770) 493-4900
Mailing address
4915 LAVISTA RD, TUCKER, GA 30084-8520
(709) 341-9077
(770) 493-4900

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3538-10
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN122555
GA

Other

Enumeration date
01/17/2008
Last updated
12/07/2023
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