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General NPI Number Information
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NPI Number | 1871988030
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Entity Type | Organization
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Legal Business Name | DR. CHANDA KALE
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 414 54TH ST GROUND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-3197
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Country | US
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Telephone | 718-439-8121
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Fax | 718-492-6993
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Provider Business Mailing Address
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Address Line | 414 54TH STREET GROUND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220
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Country | US
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Telephone | 718-439-8121
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Fax | 718-492-6993
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. CHANDA KALE
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Credential | BDS
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Telephone | 718-439-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 035474
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License Number State | NY
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