Provider Demographics
NPI:1700976602
Name:SANDLER, BENJAMIN ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ALAN
Last Name:SANDLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9704 POLISHED STONE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2801
Mailing Address - Country:US
Mailing Address - Phone:410-792-8377
Mailing Address - Fax:301-725-2147
Practice Address - Street 1:8492 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3370
Practice Address - Country:US
Practice Address - Phone:410-750-9330
Practice Address - Fax:301-725-2147
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD78591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice