Provider Demographics
NPI:1619265790
Name:ROJAS, SANDRA (DMD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6346 LANTANA RD STE 68
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6664
Mailing Address - Country:US
Mailing Address - Phone:561-439-5100
Mailing Address - Fax:
Practice Address - Street 1:6346 LANTANA RD STE 68
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6664
Practice Address - Country:US
Practice Address - Phone:561-439-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN194241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice