Provider Demographics
NPI:1508078734
Name:CUDWORTH, ROBERT FW (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FW
Last Name:CUDWORTH
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 1:708 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW ROCKFORD
Mailing Address - State:ND
Mailing Address - Zip Code:58356
Mailing Address - Country:US
Mailing Address - Phone:701-947-2354
Mailing Address - Fax:701-947-2356
Practice Address - Street 1:708 1ST AVE N
Practice Address - Street 2:
Practice Address - City:NEW ROCKFORD
Practice Address - State:ND
Practice Address - Zip Code:58356-1903
Practice Address - Country:US
Practice Address - Phone:701-947-2354
Practice Address - Fax:701-947-2356
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND19511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice