Provider Demographics
NPI:1548577646
Name:SUBRAMANIAN, SNEHA (DMD)
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:SUBRAMANIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6953
Mailing Address - Country:US
Mailing Address - Phone:480-406-9293
Mailing Address - Fax:
Practice Address - Street 1:10 S KYRENE RD
Practice Address - Street 2:#3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4524
Practice Address - Country:US
Practice Address - Phone:480-292-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ80491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice