Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | D012885 | NJ |
NPI | 1003956137 |
---|---|
Provider Name | Dr. Robert K Cardwell |
First Address | Ocean City, NJ 08226-4132 |
Second Address | Ocean City, NJ 08226-4132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |