Provider Demographics
NPI:1982644142
Name:CHANDLER, ANDREW DURBIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DURBIN
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 1:290 HIGH CHAPARRAL DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5104
Mailing Address - Country:US
Mailing Address - Phone:706-860-6443
Mailing Address - Fax:
Practice Address - Street 1:525 PLEASANT HOME RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-3525
Practice Address - Country:US
Practice Address - Phone:706-860-6443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA091481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry