Provider Demographics
NPI:1922625474
Name:SANFORD, SYDNEY DURAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:DURAN
Last Name:SANFORD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MADDIE CV
Mailing Address - Street 2:
Mailing Address - City:STEENS
Mailing Address - State:MS
Mailing Address - Zip Code:39766-5508
Mailing Address - Country:US
Mailing Address - Phone:601-562-1795
Mailing Address - Fax:
Practice Address - Street 1:301 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2155
Practice Address - Country:US
Practice Address - Phone:662-323-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4132-201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice