Provider Demographics
NPI:1952610198
Name:SANZO, MICHELE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:SANZO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 N BAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8450
Mailing Address - Country:US
Mailing Address - Phone:610-282-2249
Mailing Address - Fax:610-282-3329
Practice Address - Street 1:5596 ROUTE 309
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9515
Practice Address - Country:US
Practice Address - Phone:610-282-2249
Practice Address - Fax:610-282-3329
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0356361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry