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General NPI Number Information
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NPI Number | 1871951715
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Entity Type | Organization
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Legal Business Name | CHOPRA & TADRISSI PLLC
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Dates
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Enumeration Date | 02/07/2016
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Last Update Date | 02/07/2016
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Provider Practice Location Address
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Address Line | 14135 BALLANTYNE CORPORATE PL #215
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City | CHARLOTTE
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State | NC
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Zip | 28277-3383
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Country | US
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Telephone | 704-541-7017
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Fax |
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Provider Business Mailing Address
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Address Line | 14135 BALLANTYNE CORPORATE PL #215
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City | CHARLOTTE
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State | NC
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Zip | 28277-3383
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Country | US
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Telephone | 704-541-7017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK TADRISSI
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Credential | D.D.S.
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Telephone | 704-541-7017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 8485
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 9377
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License Number State | NC
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