Organization
RADIANCE ENDODONTICS LLC
Active
Other names
Radiance Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEILA CHANDRAHASA DMD (MANAGING MEMBER)
(941) 484-8740
Entity
Organization
Contact information
Practice address
730 THE RIALTO, VENICE, FL 34285-3524
(941) 484-8740
Mailing address
730 THE RIALTO, VENICE, FL 34285-3524
(941) 484-8740
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
01/18/2013
Last updated
06/25/2019
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