Individual
SANDRA ENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1011 ROCK QUARRY RD, RALEIGH, NC 27610-3825
(919) 833-3111
(919) 834-3118
Mailing address
1001 ROCK QUARRY RD, RALEIGH, NC 27610-3825
(919) 833-3111
(919) 834-3118
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11464
NORTH CAROLINA BOARD OF DENTISTRY LICENSE
NC
Enumeration date
11/02/2016
Last updated
03/23/2017
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