Individual
CHANDARA IM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
ARIZONA 264, SAGE MEMORIAL HOSPITAL, GANADO, AZ 86505
(928) 755-4500
Mailing address
16421 N 150TH DR, SURPRISE, AZ 85374-1473
(480) 560-7603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8233
AZ
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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