Provider Demographics
NPI:1174797369
Name:VITINS-MCKEE, SANDRA ASTRIDE (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ASTRIDE
Last Name:VITINS-MCKEE
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 1:7094 MIRAMAR RD STE 112
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2311
Mailing Address - Country:US
Mailing Address - Phone:858-578-2211
Mailing Address - Fax:858-578-2841
Practice Address - Street 1:7094 MIRAMAR RD STE 112
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2311
Practice Address - Country:US
Practice Address - Phone:858-578-2211
Practice Address - Fax:858-578-2841
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA033165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist