Provider Demographics
NPI:1861562001
Name:SUCHOW, ROBERT M (DND)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:SUCHOW
Suffix:
Gender:M
Credentials:DND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:133 MAIN ST.
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-0483
Mailing Address - Country:US
Mailing Address - Phone:908-534-5555
Mailing Address - Fax:908-534-1432
Practice Address - Street 1:133 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3698
Practice Address - Country:US
Practice Address - Phone:908-534-5555
Practice Address - Fax:908-534-1432
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ130491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics