Provider Demographics
NPI:1104896554
Name:SANDOR, ALLAN (DDS)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:SANDOR
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 1:7711 BAYMEADOWS RD E
Mailing Address - Street 2:STE 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9675
Mailing Address - Country:US
Mailing Address - Phone:904-240-0340
Mailing Address - Fax:904-527-3082
Practice Address - Street 1:7711 BAYMEADOWS RD E
Practice Address - Street 2:STE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9675
Practice Address - Country:US
Practice Address - Phone:904-240-0340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN185421223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics