Provider Demographics
NPI:1154435105
Name:SANDERS, LANCE VANDOHRN (DDS)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:VANDOHRN
Last Name:SANDERS
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 1:9130 JOLLYVILLE RD
Mailing Address - Street 2:STE. 330
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7482
Mailing Address - Country:US
Mailing Address - Phone:512-345-4334
Mailing Address - Fax:512-345-5631
Practice Address - Street 1:9130 JOLLYVILLE RD
Practice Address - Street 2:STE. 330
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7482
Practice Address - Country:US
Practice Address - Phone:512-345-4334
Practice Address - Fax:512-345-5631
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13396122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist