MEDICARE: SANDRA VO DDS

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	54220	CA

General Provider Information

NPI Number	:	1902959091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA VO DDS

Provider Business Mailing Address
First Line	:	8588 CAPE CANAVERAL AVE
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5806
Country	:	US
Telephone Number	:	310-679-0106
Fax Number	:	310-679-6698

Provider Business Practice Location Address
First Line	:	8130 MC FADDEN AVE
Second Line	:	STE 101
City	:	WESTMINSTER
State	:	CA
Zip	:	92683
Country	:	US
Telephone Number	:	714-890-9092
Fax Number	:	714-548-2740

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	03/22/2013

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