Provider Demographics
NPI:1467762088
Name:MCCARTHY, SANDRA (DDS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:MCCARTHY
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 1:11520 N CENTRAL EXPY STE 220
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6608
Mailing Address - Country:US
Mailing Address - Phone:214-340-9696
Mailing Address - Fax:214-340-0413
Practice Address - Street 1:11520 N CENTRAL EXPY STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6608
Practice Address - Country:US
Practice Address - Phone:214-340-9696
Practice Address - Fax:214-340-0413
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-16
Last Update Date:2010-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist