| Robert A. Sue D.d.s., Inc. | |
|
Suite 570 435 Arden Avenue Glendale CA 91203-1103 | |
| (818) 243-3838 | |
| (818) 243-6168 |
| Full Name | Robert A. Sue D.d.s., Inc. |
|---|---|
| Speciality | Dentist |
| Location | Suite 570, Glendale, California |
| Authorized Official Name and Position | Robert Alan Sue (DENTIST/PRESIDENT) |
| Authorized Official Contact | 8182433838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert A. Sue D.d.s., Inc. Suite 570 435 Arden Avenue Glendale CA 91203-1103 Ph: (818) 243-3838 | Robert A. Sue D.d.s., Inc. Suite 570 435 Arden Avenue Glendale CA 91203-1103 Ph: (818) 243-3838 |
| NPI Number | 1376551259 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 07/23/2021 |
| Medicare PECOS PAC ID | 1951735455 |
|---|---|
| Medicare Enrollment ID | O20191216001436 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376551259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 28096 (California) | Primary |
| Provider Name | Robert Sue |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1174739080 PECOS PAC ID: 2062732142 Enrollment ID: I20150729007311 |
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