Provider Demographics
NPI:1336778737
Name:PAULETTE SANFORD DDS, PLLC
Entity Type:Organization
Organization Name:PAULETTE SANFORD DDS, PLLC
Other - Org Name:KOHLERS CROSSING DENTAL SLEEP AND AIRWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-914-9665
Mailing Address - Street 1:4221 BENNER STE 200
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2221
Mailing Address - Country:US
Mailing Address - Phone:512-593-1764
Mailing Address - Fax:
Practice Address - Street 1:4221 BENNER STE 200
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2221
Practice Address - Country:US
Practice Address - Phone:512-593-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment