Individual
RICHARD A SANFORD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.,F.A.G.D.
Contact information
Practice address
405 SIBLEY ST, SUITE 240, SAINT PAUL, MN 55101-2975
(651) 224-6824
(651) 224-3226
Mailing address
405 SIBLEY ST, SUITE 240, SAINT PAUL, MN 55101-2975
(651) 224-6824
(651) 224-3226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7352
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27788SA
BLUE CROSS BLUE SHIELD
MN
01
—
790449
UNITED CONCORDIA
UT
Enumeration date
02/14/2006
Last updated
07/08/2007
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