Provider Demographics
NPI:1003024399
Name:SANCHEZ, GEORGE ALEXANDER (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALEXANDER
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5734
Mailing Address - Country:US
Mailing Address - Phone:561-272-0040
Mailing Address - Fax:
Practice Address - Street 1:845 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5734
Practice Address - Country:US
Practice Address - Phone:561-272-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503661223G0001X
FLDN21010122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA208149282OtherTID#