Provider Demographics
NPI:1417008400
Name:STERN, ROBERT MQ (DMD,PA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MQ
Last Name:STERN
Suffix:
Gender:M
Credentials:DMD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 E. ROUTE 70
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003
Mailing Address - Country:US
Mailing Address - Phone:856-424-4100
Mailing Address - Fax:856-424-4439
Practice Address - Street 1:1910 E. ROUTE 70
Practice Address - Street 2:SUITE 1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003
Practice Address - Country:US
Practice Address - Phone:856-424-4100
Practice Address - Fax:856-424-4439
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ161831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics