Provider Demographics
NPI:1881008233
Name:DR. ROBERT SAUNDERS
Entity Type:Organization
Organization Name:DR. ROBERT SAUNDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-293-9886
Mailing Address - Street 1:2834 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6030
Mailing Address - Country:US
Mailing Address - Phone:701-293-9886
Mailing Address - Fax:701-235-5114
Practice Address - Street 1:2834 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6030
Practice Address - Country:US
Practice Address - Phone:701-293-9886
Practice Address - Fax:701-235-5114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. ROBERT SAUNDERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND41272Medicaid