Organization
SHAM CHANDOK
Active
Other names
Consumer Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAM S CHANDOK DDS (DENTIST)
(414) 378-7971
Entity
Organization
Contact information
Practice address
5542 W FOND DU LAC AVE, MILWAUKEE, WI 53216-1200
(414) 464-1070
(414) 464-3797
Mailing address
5542 W FOND DU LAC AVE, MILWAUKEE, WI 53216-1200
(414) 464-1070
(414) 464-3797
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3107-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093974321
PROVIDER NPI NUMBER
WI
01
—
1962569012
PROVIDER NPI NUMBER
WI
Enumeration date
05/24/2014
Last updated
06/16/2014
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