Provider Demographics
NPI:1730197898
Name:MCDOUGAL, SANDRA KAYE (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAYE
Last Name:MCDOUGAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2681
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-2681
Mailing Address - Country:US
Mailing Address - Phone:972-612-2200
Mailing Address - Fax:
Practice Address - Street 1:400 MAPLELAWN CT
Practice Address - Street 2:STE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-5736
Practice Address - Country:US
Practice Address - Phone:597-261-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry