Provider Demographics
NPI:1891788071
Name:SANDERS, CARY WADE (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:WADE
Last Name:SANDERS
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 VERMONT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2900
Mailing Address - Country:US
Mailing Address - Phone:970-482-1477
Mailing Address - Fax:
Practice Address - Street 1:2000 VERMONT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2900
Practice Address - Country:US
Practice Address - Phone:970-482-1477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist