Provider Demographics
NPI:1942339940
Name:SINCLAIR, CASSANDRA S (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:S
Last Name:SINCLAIR
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 1:1000 TANNER FORD BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29410-4707
Mailing Address - Country:US
Mailing Address - Phone:843-818-5437
Mailing Address - Fax:
Practice Address - Street 1:1000 TANNER FORD BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29410-4707
Practice Address - Country:US
Practice Address - Phone:843-818-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice