Provider Demographics
NPI:1528045226
Name:SUNDQUIST, ROBERT E (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:SUNDQUIST
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 TROON RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2371
Mailing Address - Country:US
Mailing Address - Phone:302-677-1829
Mailing Address - Fax:
Practice Address - Street 1:253 NE FRONT ST
Practice Address - Street 2:MILFORD STATE SERVICE CENTER AT RIVERWALK DENTAL CLINIC
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1431
Practice Address - Country:US
Practice Address - Phone:302-424-7160
Practice Address - Fax:302-424-7203
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2011-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001187122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist