Provider Demographics
NPI:1023039484
Name:SANDHERR, ROBERT LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LAWRENCE
Last Name:SANDHERR
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 1:2040 MAHANTONGO ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3110
Mailing Address - Country:US
Mailing Address - Phone:570-622-2657
Mailing Address - Fax:
Practice Address - Street 1:2040 MAHANTONGO ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3110
Practice Address - Country:US
Practice Address - Phone:570-622-2657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO18583L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist