Provider Demographics
NPI:1871770172
Name:SANCHEZ, M. CONSUELO (DMD)
Entity type:Individual
Prefix:DR
First Name:M.
Middle Name:CONSUELO
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 PHOENIX AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4471
Mailing Address - Country:US
Mailing Address - Phone:860-741-8633
Mailing Address - Fax:860-741-7032
Practice Address - Street 1:101 PHOENIX AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4471
Practice Address - Country:US
Practice Address - Phone:860-741-8633
Practice Address - Fax:860-741-7032
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0071341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry