Provider Demographics
NPI:1851093033
Name:SANDERFOOT, ALISON MARIA (RDH)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIA
Last Name:SANDERFOOT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MARIA
Other - Last Name:PICKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:3950 EVERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8903
Mailing Address - Country:US
Mailing Address - Phone:920-734-4649
Mailing Address - Fax:715-842-7331
Practice Address - Street 1:3950 EVERGREEN CT
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8903
Practice Address - Country:US
Practice Address - Phone:920-734-4649
Practice Address - Fax:715-842-7331
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1003773124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist