Provider Demographics
NPI:1679661516
Name:CHANDRA, SAPNA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:
Last Name:CHANDRA
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 1:10411 MONCREIFFE RD # 107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7819
Mailing Address - Country:US
Mailing Address - Phone:919-405-7075
Mailing Address - Fax:
Practice Address - Street 1:10411 MONCREIFFE RD # 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7819
Practice Address - Country:US
Practice Address - Phone:919-405-7075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7260122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist