Provider Demographics
NPI:1306268172
Name:SANDOR, MARILYN CLAIRE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:CLAIRE
Last Name:SANDOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11543 AERIE LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-4334
Mailing Address - Country:US
Mailing Address - Phone:239-269-3703
Mailing Address - Fax:
Practice Address - Street 1:4529 EXECUTIVE DR STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9032
Practice Address - Country:US
Practice Address - Phone:239-592-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry