Provider Demographics
NPI:1003995556
Name:BURNS-SANCHEZ, SUSAN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:BURNS-SANCHEZ
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 1:1117 RIO RANCHO BLVD
Mailing Address - Street 2:STE 19
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124
Mailing Address - Country:US
Mailing Address - Phone:505-896-4657
Mailing Address - Fax:505-994-1720
Practice Address - Street 1:1117 RIO RANCHO DR SE
Practice Address - Street 2:STE 19
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1859
Practice Address - Country:US
Practice Address - Phone:505-896-4657
Practice Address - Fax:505-994-1720
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1854122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist