Provider Demographics
NPI:1053634238
Name:CHANDLER, BRYANNE D (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYANNE
Middle Name:D
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2667
Mailing Address - Country:US
Mailing Address - Phone:860-313-0025
Mailing Address - Fax:860-313-0801
Practice Address - Street 1:1245 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2667
Practice Address - Country:US
Practice Address - Phone:860-313-0025
Practice Address - Fax:860-313-0801
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0101231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice