Provider Demographics
NPI:1649319021
Name:DRS. SANDLER AND KAUFFMAN A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:DRS. SANDLER AND KAUFFMAN A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:KAUFFMAN
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:858-345-1960
Mailing Address - Street 1:665 SAN RODOLFO DR
Mailing Address - Street 2:SUITE 117
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2047
Mailing Address - Country:US
Mailing Address - Phone:858-345-1960
Mailing Address - Fax:858-345-1291
Practice Address - Street 1:665 SAN RODOLFO DR
Practice Address - Street 2:SUITE 117
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2047
Practice Address - Country:US
Practice Address - Phone:858-345-1960
Practice Address - Fax:858-345-1291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169461223G0001X
MA156331223G0001X
CA540741223G0001X
CA540751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty