Provider Demographics
NPI:1508805102
Name:SANCHEZ, GEORGE A (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 W MARION AVE
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4436
Mailing Address - Country:US
Mailing Address - Phone:941-637-0101
Mailing Address - Fax:941-637-6809
Practice Address - Street 1:351 W MARION AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4436
Practice Address - Country:US
Practice Address - Phone:941-637-0101
Practice Address - Fax:941-637-6809
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL131641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL69360OtherBC.BS OF FLORIDA PROVIDER