Provider Demographics
NPI:1104181049
Name:BARTEE, SANDRA JOYCE (RDH,BS)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JOYCE
Last Name:BARTEE
Suffix:
Gender:F
Credentials:RDH,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10412 MANZANILLO AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1725
Mailing Address - Country:US
Mailing Address - Phone:505-294-8178
Mailing Address - Fax:
Practice Address - Street 1:NOVITSKI HL
Practice Address - Street 2:1 UNM
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM308124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist