Provider Demographics
NPI:1710047774
Name:TERMOTTO, SANDY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:S
Last Name:TERMOTTO
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 1:11706 MERCY BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1751
Mailing Address - Country:US
Mailing Address - Phone:912-925-3400
Mailing Address - Fax:912-925-2146
Practice Address - Street 1:11706 MERCY BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1751
Practice Address - Country:US
Practice Address - Phone:912-925-3400
Practice Address - Fax:912-925-2146
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA80911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice