Provider Demographics
NPI:1407206030
Name:SANDY DENTAL INC
Entity Type:Organization
Organization Name:SANDY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BORGES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-266-5222
Mailing Address - Street 1:8000 W FLAGLER ST STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2153
Mailing Address - Country:US
Mailing Address - Phone:305-266-7744
Mailing Address - Fax:305-267-3289
Practice Address - Street 1:8000 W FLAGLER ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2153
Practice Address - Country:US
Practice Address - Phone:305-266-5222
Practice Address - Fax:305-267-3289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty