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General NPI Number Information
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NPI Number | 1265537823
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Entity Type | Individual
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Provider Name | WENDY CHU TANDAR DMD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 3377 S ORCHARD DR
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City | BOUNTIFUL
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State | UT
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Zip | 84010-8005
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Country | US
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Telephone | 801-951-8038
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Fax |
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Provider Business Mailing Address
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Address Line | 1937 E HERBERT AVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-1833
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Country | US
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Telephone | 801-520-0410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5596980-9926
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License Number State | UT
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