MEDICARE: DR. PAUL SANCHEZ D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	49662	CA

General Provider Information

NPI Number	:	1548398381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SANCHEZ D.D.S.

Provider Business Mailing Address
First Line	:	8201 PAWTUCKET DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-6735
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 SEVILLE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-6028
Country	:	US
Telephone Number	:	323-585-0153
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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