Provider Demographics
NPI:1427413509
Name:SANDHU, MEHTAB (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEHTAB
Middle Name:
Last Name:SANDHU
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 1:305 E FM 544 UNIT 915
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4057
Mailing Address - Country:US
Mailing Address - Phone:972-423-0415
Mailing Address - Fax:
Practice Address - Street 1:305 E FM 544
Practice Address - Street 2:STE 915
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4056
Practice Address - Country:US
Practice Address - Phone:972-423-0415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31571122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist