Provider Demographics
NPI:1164494191
Name:OSWALD, ROBERT J (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:OSWALD
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 1:11820 NE 128TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11820 NE 128TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7201
Practice Address - Country:US
Practice Address - Phone:425-821-7100
Practice Address - Fax:425-820-8208
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA46601223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics