Provider Demographics
NPI:1518677897
Name:DENTAL AESTHETICS OF NORTH ANDOVER PLLC
Entity Type:Organization
Organization Name:DENTAL AESTHETICS OF NORTH ANDOVER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VANDNA
Authorized Official - Middle Name:SUDEEP
Authorized Official - Last Name:CHAWLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-751-2929
Mailing Address - Street 1:125 PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3379
Mailing Address - Country:US
Mailing Address - Phone:347-751-2929
Mailing Address - Fax:
Practice Address - Street 1:33 WALKER RD STE 2B
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1900
Practice Address - Country:US
Practice Address - Phone:347-751-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental