Chandara Im, DDS

NPI #1902184757 in Ganado, Arizona

Provider Information

NPI Number: 1902184757
Entity Type: Individual
Name: Chandara Im, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 28, 2011
Last Updated: Jul 28, 2011

Practice Location

Address: ARIZONA 264
Address 2: SAGE MEMORIAL HOSPITAL
City: Ganado
State: Arizona
ZIP Code: 86505
Phone: (928) 755-4500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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