Provider Demographics
NPI:1184629008
Name:MADISON, SANDRA (DDS MS PLLC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:MADISON
Suffix:
Gender:F
Credentials:DDS MS PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 YORKSHIRE ST
Mailing Address - Street 2:STE B
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2751
Mailing Address - Country:US
Mailing Address - Phone:828-277-7668
Mailing Address - Fax:
Practice Address - Street 1:5 YORKSHIRE ST
Practice Address - Street 2:STE B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2751
Practice Address - Country:US
Practice Address - Phone:828-277-7668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC-45101223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics