Provider Demographics
NPI:1205083490
Name:CHANDLER, ANDREW STEVEN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEVEN
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 FOLLY RD
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2508
Mailing Address - Country:US
Mailing Address - Phone:843-793-1177
Mailing Address - Fax:843-793-1174
Practice Address - Street 1:349 FOLLY RD
Practice Address - Street 2:SUITE 1-C
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2508
Practice Address - Country:US
Practice Address - Phone:843-793-1177
Practice Address - Fax:843-793-1174
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist