Provider Demographics
NPI:1346614807
Name:MONTANO, SANDY FLETCHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:FLETCHER
Last Name:MONTANO
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 1:8250 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3502
Mailing Address - Country:US
Mailing Address - Phone:786-955-7284
Mailing Address - Fax:
Practice Address - Street 1:8250 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3502
Practice Address - Country:US
Practice Address - Phone:786-955-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22396122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist