Provider Demographics
NPI:1558450015
Name:MARC A. SANDER, D.D.S., P.A.
Entity Type:Organization
Organization Name:MARC A. SANDER, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-782-3334
Mailing Address - Street 1:2323 NE 26TH AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1147
Mailing Address - Country:US
Mailing Address - Phone:954-782-3334
Mailing Address - Fax:954-580-3511
Practice Address - Street 1:2323 NE 26TH AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:954-782-3334
Practice Address - Fax:954-580-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 75951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty