Provider Demographics
NPI:1831389139
Name:SANDRAS, DANT ASHLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:DANT
Middle Name:ASHLEY
Last Name:SANDRAS
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 1:13373 HIGHWAY 3235
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-2443
Mailing Address - Country:US
Mailing Address - Phone:985-798-3000
Mailing Address - Fax:985-798-3803
Practice Address - Street 1:13373 HIGHWAY 3235
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-2443
Practice Address - Country:US
Practice Address - Phone:985-798-3000
Practice Address - Fax:985-798-3803
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5369122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist