Provider Demographics
NPI:1205994498
Name:SIEBER, SANDRA L (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:SIEBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 N MACARTHUR BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3637
Mailing Address - Country:US
Mailing Address - Phone:972-252-4606
Mailing Address - Fax:972-252-1341
Practice Address - Street 1:3636 N MACARTHUR BLVD
Practice Address - Street 2:STE 140
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3637
Practice Address - Country:US
Practice Address - Phone:972-252-4606
Practice Address - Fax:972-252-1341
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice