Provider Demographics
NPI:1083639504
Name:SANCHEZ, ANDRES ROBERTO (DDS)
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:ROBERTO
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 1:800 PRAIRIE CENTER DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7328
Mailing Address - Country:US
Mailing Address - Phone:952-567-7457
Mailing Address - Fax:952-567-7459
Practice Address - Street 1:800 PRAIRIE CENTER DRIVE
Practice Address - Street 2:SUITE 220
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7341
Practice Address - Country:US
Practice Address - Phone:952-567-7457
Practice Address - Fax:952-567-7459
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNS131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics