| NPI | 1013480565 |
|---|---|
| Former Name | CHANDLER ASHLEE WEISBART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 7164) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 0006587-C1) |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2023-08-04 |