Provider Demographics
NPI:1477649705
Name:SANDERS, JAMES THOMAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:SANDERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:J
Other - Middle Name:THOMAS
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PC
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:AL
Mailing Address - Zip Code:36049
Mailing Address - Country:US
Mailing Address - Phone:334-335-3697
Mailing Address - Fax:334-335-4128
Practice Address - Street 1:1666 S FOREST AVE
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049
Practice Address - Country:US
Practice Address - Phone:334-335-3697
Practice Address - Fax:334-335-4128
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3795122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist