Provider Demographics
NPI:1629115639
Name:STEEN LAW, SANDRA LYNN (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNN
Last Name:STEEN LAW
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:LYNN
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2100 OTTER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-1064
Mailing Address - Country:US
Mailing Address - Phone:651-762-5783
Mailing Address - Fax:
Practice Address - Street 1:5804 EXCELSIOR BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2830
Practice Address - Country:US
Practice Address - Phone:952-922-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND109911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics