Provider Demographics
NPI:1609010644
Name:SANCHEZ, ROLAND KENT II (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:KENT
Last Name:SANCHEZ
Suffix:II
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 1:704 CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-2629
Mailing Address - Country:US
Mailing Address - Phone:505-864-7000
Mailing Address - Fax:505-864-6474
Practice Address - Street 1:704 CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-2629
Practice Address - Country:US
Practice Address - Phone:505-864-7000
Practice Address - Fax:505-864-6474
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist