Basic Information
| Provider Information | |||||||||
| NPI: | 1023084514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALIK | ||||||||
| FirstName: | CHANDER | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BX 2658 | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9418612900 | ||||||||
| FaxNumber: | 9418612868 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 RINGLING BOULEVARD | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9418612900 | ||||||||
| FaxNumber: | 9418612868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DN8399 | FL | Y | Dental Providers | Dentist |
No ID Information.