Provider Demographics
NPI:1548411424
Name:SOWALSKY, ROBERT (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:SOWALSKY
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 1:1549 UNION STREET,
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6022
Mailing Address - Country:US
Mailing Address - Phone:518-372-0067
Mailing Address - Fax:
Practice Address - Street 1:1549 UNION STREET
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6022
Practice Address - Country:US
Practice Address - Phone:518-372-0067
Practice Address - Fax:518-372-1346
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist