Individual
DR. CHANDAN S WALIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
3800 W RAY RD STE B6, CHANDLER, AZ 85226-5940
(917) 913-9143
(480) 407-6533
Mailing address
20652 N 53RD AVE, GLENDALE, AZ 85308-9309
(917) 913-9143
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
050252
NY
1223P0300X
Periodontics
22D102267203
NJ
1223P0300X
Periodontics
Primary
D 7738
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
537911
—
AZ
Enumeration date
10/05/2006
Last updated
06/02/2021
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