Provider Demographics
NPI:1851602296
Name:CHANDRA, ABHISHEK (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABHISHEK
Middle Name:
Last Name:CHANDRA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 PITTSTOWN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PITTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08867-4166
Mailing Address - Country:US
Mailing Address - Phone:908-735-7790
Mailing Address - Fax:908-735-6351
Practice Address - Street 1:371 PITTSTOWN RD
Practice Address - Street 2:SUITE A
Practice Address - City:PITTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08867-4166
Practice Address - Country:US
Practice Address - Phone:908-735-7790
Practice Address - Fax:908-735-6351
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024618001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice