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SANDRA BADROUS DMD
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1912575168
Individual Registrant: SANDRA BADROUS DMD
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
2501 MAYWOOD ST EUSTIS, FL 32726-2064 US
Tel: 352-434-5605 Fax: --
Tel: 352-434-5605 Fax: --
Contact information for business:
2501 MAYWOOD ST EUSTIS, FL 32726-2064 US
Tel: 352-434-5605 Fax: --
Tel: 352-434-5605 Fax: --
Registration Information:
NPI: 1912575168
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | FL | DN25976 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
