Provider Demographics
NPI:1568782274
Name:SANDERS, ALIX H JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALIX
Middle Name:H
Last Name:SANDERS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 ROWLETT RD.
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089
Mailing Address - Country:US
Mailing Address - Phone:972-463-1001
Mailing Address - Fax:972-463-1009
Practice Address - Street 1:7100 ROWLETT RD.
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089
Practice Address - Country:US
Practice Address - Phone:972-463-1001
Practice Address - Fax:972-463-1009
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23037122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist