Provider Demographics
NPI:1851573653
Name:SINCLAIR, SANDRA COLEMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:COLEMAN
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:KAY
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1405 W KOENIG LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1413
Mailing Address - Country:US
Mailing Address - Phone:512-467-0555
Mailing Address - Fax:
Practice Address - Street 1:1405 W KOENIG LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1413
Practice Address - Country:US
Practice Address - Phone:512-467-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice