Provider Demographics
NPI:1487084166
Name:CHANDER COSMETIC DENTISTRY, PLLC
Entity type:Organization
Organization Name:CHANDER COSMETIC DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-273-8827
Mailing Address - Street 1:2055 N ALMA SCHOOL RD
Mailing Address - Street 2:#22
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2866
Mailing Address - Country:US
Mailing Address - Phone:480-273-8827
Mailing Address - Fax:480-273-8498
Practice Address - Street 1:2055 N ALMA SCHOOL RD
Practice Address - Street 2:#22
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2866
Practice Address - Country:US
Practice Address - Phone:480-273-8827
Practice Address - Fax:480-273-8498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty