Provider Demographics
NPI:1407984495
Name:SANFORD, ROSS E (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:E
Last Name:SANFORD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 VIA LINDA CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6150
Mailing Address - Country:US
Mailing Address - Phone:435-922-5858
Mailing Address - Fax:
Practice Address - Street 1:2420 VIA LINDA CIR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6150
Practice Address - Country:US
Practice Address - Phone:435-922-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK12141223G0001X
OR91781223G0001X
NV10591223G0001X
UT141816-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice