Provider Demographics
NPI:1003956137
Name:CARDWELL, ROBERT K (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:CARDWELL
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 1:232 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-4132
Mailing Address - Country:US
Mailing Address - Phone:609-398-8866
Mailing Address - Fax:609-398-1277
Practice Address - Street 1:232 WEST AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-4132
Practice Address - Country:US
Practice Address - Phone:609-398-8866
Practice Address - Fax:609-398-1277
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD012885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist