Provider Demographics
NPI:1427131952
Name:SANDERS, ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:SANDERS
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 1:396 LIBERTY STREET
Mailing Address - Street 2:THOMASVILLE DENTAL CENTER
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757
Mailing Address - Country:US
Mailing Address - Phone:229-227-9070
Mailing Address - Fax:
Practice Address - Street 1:396 LIBERTY STREET
Practice Address - Street 2:THOMASVILLE DENTAL CENTER
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757
Practice Address - Country:US
Practice Address - Phone:229-227-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice