Provider Demographics
NPI:1740695931
Name:MONTES, SANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:MONTES
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 1:120 E HIGHWAY 550
Mailing Address - Street 2:
Mailing Address - City:BERNALILLO
Mailing Address - State:NM
Mailing Address - Zip Code:87004-5967
Mailing Address - Country:US
Mailing Address - Phone:505-393-5555
Mailing Address - Fax:
Practice Address - Street 1:120 E HIGHWAY 550
Practice Address - Street 2:
Practice Address - City:BERNALILLO
Practice Address - State:NM
Practice Address - Zip Code:87004-5967
Practice Address - Country:US
Practice Address - Phone:505-393-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190301141223G0001X
NMDD41011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice