Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 6215 | LA |
NPI | 1003190273 |
---|---|
Provider Name | Dr. Andrew Victor Sanchez |
First Address | Fort Wainwright, AK 99703-5007 |
Second Address | Fort Wainwright, AK 99703-5007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 02/08/2012 |