Provider Demographics
NPI:1053457697
Name:DR ROBERT STERN PA
Entity Type:Organization
Organization Name:DR ROBERT STERN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-691-7142
Mailing Address - Street 1:1171 E LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4200
Mailing Address - Country:US
Mailing Address - Phone:856-691-7142
Mailing Address - Fax:856-691-1498
Practice Address - Street 1:1171 E LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4200
Practice Address - Country:US
Practice Address - Phone:856-691-7142
Practice Address - Fax:856-691-1498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ161831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty