Provider Demographics
NPI:1689384422
Name:SANDY GABRIEL, DDS INC
Entity Type:Organization
Organization Name:SANDY GABRIEL, DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-218-8583
Mailing Address - Street 1:3611 W 5TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6426
Mailing Address - Country:US
Mailing Address - Phone:805-985-1800
Mailing Address - Fax:805-984-0598
Practice Address - Street 1:3611 W 5TH ST STE A
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6426
Practice Address - Country:US
Practice Address - Phone:805-985-1800
Practice Address - Fax:805-984-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty