Provider Demographics
NPI:1326075722
Name:CHANG, SANDRA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:S
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:410 ORCHARD HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1836
Mailing Address - Country:US
Mailing Address - Phone:734-981-7477
Mailing Address - Fax:734-981-0328
Practice Address - Street 1:42301 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-9801
Practice Address - Country:US
Practice Address - Phone:764-981-7477
Practice Address - Fax:734-981-0328
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010182491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics