Provider Demographics
NPI:1225021272
Name:SANDERSON, HELEN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:MARIE
Last Name:SANDERSON
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 1:4560 ADMIRALTY WAY
Mailing Address - Street 2:SUITE #250
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5423
Mailing Address - Country:US
Mailing Address - Phone:310-822-3472
Mailing Address - Fax:310-306-1062
Practice Address - Street 1:4560 ADMIRALTY WAY
Practice Address - Street 2:SUITE #250
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5423
Practice Address - Country:US
Practice Address - Phone:310-822-3472
Practice Address - Fax:310-306-1062
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA444401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice