Provider Demographics
NPI:1790903672
Name:SANDEEP SOOD D.D.S. P.C.
Entity Type:Organization
Organization Name:SANDEEP SOOD D.D.S. P.C.
Other - Org Name:HOLT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-694-2501
Mailing Address - Street 1:2205 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-1203
Mailing Address - Country:US
Mailing Address - Phone:517-694-2501
Mailing Address - Fax:517-694-2637
Practice Address - Street 1:2205 CEDAR ST
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1203
Practice Address - Country:US
Practice Address - Phone:517-694-2501
Practice Address - Fax:517-694-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901017508122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty