Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 7666 | KY |
NPI | 1134143423 |
---|---|
Provider Name | Dr. Nancy L Sandmann |
First Address | Albuquerque, NM 87114-4599 |
Second Address | Albuquerque, NM 87120-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39056261 | (05) | NM |
805898 | (05) | AZ |