Provider Demographics
NPI:1003008418
Name:CUARTAS, SANDRA P (DDS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:P
Last Name:CUARTAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 RACQUET CLUB RD APT N508
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1193
Mailing Address - Country:US
Mailing Address - Phone:954-638-1030
Mailing Address - Fax:
Practice Address - Street 1:6600 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6450
Practice Address - Country:US
Practice Address - Phone:305-821-2611
Practice Address - Fax:305-556-0746
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 181131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice