Individual
MATTHEW SANDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6535 W NORTH AVE, WAUWATOSA, WI 53213-2016
(414) 258-8190
Mailing address
6535 W NORTH AVE, WAUWATOSA, WI 53213-2016
(414) 258-8190
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6664-15
WI
1223D0001X
Public Health Dentistry
6664-15
WI
1223G0001X
General Practice Dentistry
6664-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2010
Last updated
02/26/2025
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