Provider Demographics
NPI:1912071713
Name:SUNDAY, RICHARD HENRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HENRY
Last Name:SUNDAY
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 1:300 EDGAR AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-3216
Mailing Address - Country:US
Mailing Address - Phone:570-784-5156
Mailing Address - Fax:
Practice Address - Street 1:300 EDGAR AVE
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-3216
Practice Address - Country:US
Practice Address - Phone:570-784-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019498L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist