Provider Demographics
NPI:1245352988
Name:CURTIS W SANDAHL DDS INC
Entity type:Organization
Organization Name:CURTIS W SANDAHL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SANDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-485-5331
Mailing Address - Street 1:500 ESPLANADE DR
Mailing Address - Street 2:SUITE 1280
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-5072
Mailing Address - Country:US
Mailing Address - Phone:805-485-5331
Mailing Address - Fax:805-983-8711
Practice Address - Street 1:500 ESPLANADE DR
Practice Address - Street 2:SUITE 1280
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-5072
Practice Address - Country:US
Practice Address - Phone:805-485-5331
Practice Address - Fax:805-983-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty