Provider Demographics
NPI:1811368715
Name:M SANCHEZ DDS DENTAL INC.
Entity Type:Organization
Organization Name:M SANCHEZ DDS DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYO-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-905-3404
Mailing Address - Street 1:15701 AMAR RD
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-3011
Mailing Address - Country:US
Mailing Address - Phone:626-723-4465
Mailing Address - Fax:
Practice Address - Street 1:15701 AMAR RD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-3011
Practice Address - Country:US
Practice Address - Phone:626-723-4465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-18
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty