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General NPI Number Information
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NPI Number | 1316239908
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Entity Type | Organization
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Legal Business Name | SANDRA BARLOW DOONQUAH, DDS, PLLC
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Dates
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Enumeration Date | 05/14/2011
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Last Update Date | 05/14/2011
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Provider Practice Location Address
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Address Line | 2509 RICHARDSON DR SUITE B
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City | REIDSVILLE
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State | NC
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Zip | 27320-5900
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Country | US
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Telephone | 336-394-4191
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Fax |
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Provider Business Mailing Address
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Address Line | 306 LAKEWALK DR
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City | REIDSVILLE
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State | NC
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Zip | 27320-9608
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Country | US
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Telephone | 336-394-4191
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDRA BARLOW DOONQUAH
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Credential | DDS
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Telephone | 336-394-4191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8804
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License Number State | NC
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