Healthcare Provider Details
I. General information
NPI: 1275457814
Provider Name (Legal Business Name): MARS FAMILY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
221 CROWE AVE
MARS PA
16046-3405
US
IV. Provider business mailing address
221 CROWE AVE
MARS PA
16046-3405
US
V. Phone/Fax
- Phone: 724-376-7161
- Fax:
- Phone: 724-376-7161
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEVESHI
CHANDAN
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 412-692-1168