Provider Demographics
NPI:1649356874
Name:CHANDLER, THOMAS EARL (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EARL
Last Name:CHANDLER
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 1:262 NORTH 350 EAST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:UT
Mailing Address - Zip Code:84624
Mailing Address - Country:US
Mailing Address - Phone:435-864-3881
Mailing Address - Fax:
Practice Address - Street 1:262 NORTH 350 EAST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:UT
Practice Address - Zip Code:84624
Practice Address - Country:US
Practice Address - Phone:435-864-3881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT138183-89031223G0001X
UT138183-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1381838903OtherDENTAL LICENSE
UT1381839922OtherANESTHESIA CLASS II PERMI
UT1381839922OtherANESTHESIA CLASS II PERMI