Provider Demographics
NPI:1003031386
Name:SANCHEZ, CARLOS E (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
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 1:2604 REMBRANDT PL
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-0377
Mailing Address - Country:US
Mailing Address - Phone:209-836-4277
Mailing Address - Fax:209-836-4107
Practice Address - Street 1:1433 N TRACY BLVD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3445
Practice Address - Country:US
Practice Address - Phone:209-836-4277
Practice Address - Fax:209-836-4107
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice