Provider Demographics
NPI:1124476635
Name:SANOVICH, DANNY (DMD)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:
Last Name:SANOVICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:SANOVICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:12740 HILLCREST RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2050
Mailing Address - Country:US
Mailing Address - Phone:972-776-4888
Mailing Address - Fax:972-833-7001
Practice Address - Street 1:12740 HILLCREST RD STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2050
Practice Address - Country:US
Practice Address - Phone:972-776-4888
Practice Address - Fax:972-833-7001
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRP15711223S0112X
TX359141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery