Provider Demographics
NPI:1952396137
Name:SANCHEZ, MICHAEL P (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:SANCHEZ
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 1:12150 E 96TH ST N
Mailing Address - Street 2:STE 106
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5338
Mailing Address - Country:US
Mailing Address - Phone:918-272-0707
Mailing Address - Fax:918-272-0709
Practice Address - Street 1:12150 E 96TH ST N
Practice Address - Street 2:STE 106
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5338
Practice Address - Country:US
Practice Address - Phone:918-272-0707
Practice Address - Fax:918-272-0709
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK53301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice