Individual
ANASTASIA SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2004 E RIVERSIDE BLVD, LOVES PARK, IL 61111-4856
(312) 721-3405
Mailing address
5600 S NARRAGANSETT AVE APT 2E, CHICAGO, IL 60638-3400
(312) 721-3405
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.037095
IL
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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