Provider Demographics
NPI:1437463684
Name:KANCHARLA, ASHALATHA (DDS)
Entity Type:Individual
Prefix:
First Name:ASHALATHA
Middle Name:
Last Name:KANCHARLA
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 1:1206 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3813
Mailing Address - Country:US
Mailing Address - Phone:484-366-3775
Mailing Address - Fax:
Practice Address - Street 1:6001 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1410
Practice Address - Country:US
Practice Address - Phone:215-724-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist