Provider Demographics
NPI:1669802633
Name:STEVEN MICHAEL SANCHEZ DDS PPLC
Entity type:Organization
Organization Name:STEVEN MICHAEL SANCHEZ DDS PPLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-417-9781
Mailing Address - Street 1:230 W BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2805
Mailing Address - Country:US
Mailing Address - Phone:830-816-5228
Mailing Address - Fax:
Practice Address - Street 1:230 W BANDERA RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2805
Practice Address - Country:US
Practice Address - Phone:830-816-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21789122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1679648133Medicaid