Provider Demographics
NPI:1023037942
Name:KING, SANFORD B (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:B
Last Name:KING
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 1:219 E BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2116
Mailing Address - Country:US
Mailing Address - Phone:626-966-9971
Mailing Address - Fax:626-966-9534
Practice Address - Street 1:219 E BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2116
Practice Address - Country:US
Practice Address - Phone:626-966-9971
Practice Address - Fax:626-966-9534
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics