Provider Demographics
NPI:1851964175
Name:PEREZ, SANDRA CAMILA (DDS/MPH)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:CAMILA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DDS/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 S BLUEBONNET LN
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-2941
Mailing Address - Country:US
Mailing Address - Phone:979-583-6578
Mailing Address - Fax:
Practice Address - Street 1:3520 S NEW BRAUNFELS AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1406
Practice Address - Country:US
Practice Address - Phone:210-532-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0120831223P0221X
TX375391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry