Provider Demographics
NPI:1588784540
Name:SJOBERG, CRAIG C (DDS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:C
Last Name:SJOBERG
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 1:663 OROFINO CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6951
Mailing Address - Country:US
Mailing Address - Phone:925-484-0454
Mailing Address - Fax:925-484-4323
Practice Address - Street 1:5000 PLEASANTON AVE
Practice Address - Street 2:SUITE #110
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7052
Practice Address - Country:US
Practice Address - Phone:925-484-4406
Practice Address - Fax:925-484-0346
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAS9438210122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist