Provider Demographics
NPI:1003190273
Name:SANCHEZ, ANDREW VICTOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:VICTOR
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1060 GAFFNEY RD STOP 7500
Mailing Address - Street 2:U S ARMY DENTAL ACTIVITY
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-5007
Mailing Address - Country:US
Mailing Address - Phone:907-361-5530
Mailing Address - Fax:907-361-4859
Practice Address - Street 1:1060 GAFFNEY RD STOP 7500
Practice Address - Street 2:U S ARMY DENTAL ACTIVITY
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-5007
Practice Address - Country:US
Practice Address - Phone:907-361-5530
Practice Address - Fax:907-361-4859
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA6215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist