Provider Demographics
NPI:1609991066
Name:SANDOR, BARRY L (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:SANDOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 FOUNTAIN VIEW DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4586
Mailing Address - Country:US
Mailing Address - Phone:732-462-8877
Mailing Address - Fax:
Practice Address - Street 1:70 SCHANCK RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5309
Practice Address - Country:US
Practice Address - Phone:732-462-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI017436001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice