Most Relevant Information
Provider Data
| NPI Number: | 1003562802 |
| Provider Name: | DIVYA CHAWLA DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | DN122831 |
Most Important Dates
| Enumeration Date: | 03/01/2022 |
| Last Updated: | 09/04/2022 |
Provider Practice Location
1120 15TH ST
AUGUSTA
GA
309128197
Practice Location Phone/Fax
| Phone: | 7067212371 |
| Fax: |
Provider Mailing Location
750 MILTON OAKS DR
ALPHARETTA
GA
300228197
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |