NPI 1821375809

Gangadhara Chandu

Practitioner Dental Assistant Owings Mills, MD

Practice location

Address: 400 Red Brook Blvd, Owings Mills, MD 21117-5172
Phone: (312) 121-2222

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 44444444444444444444 (IA)

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Registry record

NPI: 1821375809
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Nov 2011
Record last updated: 4 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.