Provider Demographics
NPI:1558680439
Name:SANCHEZ, MAYRA (DDS)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:
Last Name:SANCHEZ
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 1:5845 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3316
Mailing Address - Country:US
Mailing Address - Phone:305-261-8025
Mailing Address - Fax:305-261-4936
Practice Address - Street 1:5845 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3316
Practice Address - Country:US
Practice Address - Phone:305-261-8025
Practice Address - Fax:305-261-4936
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9618122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist