Provider Demographics
NPI:1376511352
Name:SANDQUIST, CAROL P (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:P
Last Name:SANDQUIST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1715
Mailing Address - Country:US
Mailing Address - Phone:516-248-2822
Mailing Address - Fax:516-739-3123
Practice Address - Street 1:414 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1715
Practice Address - Country:US
Practice Address - Phone:516-248-2822
Practice Address - Fax:516-739-3123
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037620122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist