Individual
DR. SHRUTI CHANDNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
5412 MONTGOMERY HWY STE 8, DOTHAN, AL 36303-1657
(334) 983-1730
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(601) 668-8412
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1341
OK
1223G0001X
General Practice Dentistry
2951000806
MI
1223P0221X
Pediatric Dentistry
Primary
D.007245-C1
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2951000806
BOARD OF DENTISTRY DENTAL EDUCATION LIMITED LICENSE
MI
Enumeration date
02/18/2019
Last updated
03/22/2024
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