Provider Demographics
NPI:1578792552
Name:CARVALHO, SANDRA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:E
Last Name:CARVALHO
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 1:16871 PATIO VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1621
Mailing Address - Country:US
Mailing Address - Phone:954-732-1374
Mailing Address - Fax:
Practice Address - Street 1:2820 OAK AVE
Practice Address - Street 2:
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-5208
Practice Address - Country:US
Practice Address - Phone:305-460-4499
Practice Address - Fax:305-441-0883
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL188111223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics