Provider Demographics
NPI:1811005663
Name:SANDAHL, CURTIS WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:WILLIAM
Last Name:SANDAHL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ESPLANADE DR
Mailing Address - Street 2:STE 1280
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036
Mailing Address - Country:US
Mailing Address - Phone:805-485-5331
Mailing Address - Fax:805-485-5330
Practice Address - Street 1:500 E ESPLANADE DR
Practice Address - Street 2:STE 1280
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2110
Practice Address - Country:US
Practice Address - Phone:805-485-5331
Practice Address - Fax:805-485-5330
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist