Provider Demographics
NPI:1871500033
Name:CHANDLER, NATHAN ERIC (DDS)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:ERIC
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 E 9400 S
Mailing Address - Street 2:STE 101
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094
Mailing Address - Country:US
Mailing Address - Phone:801-571-3446
Mailing Address - Fax:801-571-1340
Practice Address - Street 1:870 E 9400 S
Practice Address - Street 2:STE 101
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094
Practice Address - Country:US
Practice Address - Phone:801-571-3446
Practice Address - Fax:801-571-1340
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53867669922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist