Organization
DR. RICHARD J. SUNDBERG D.D.S., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JON SUNDBERG D.D.S. (PRESIDENT)
(509) 529-3762
Entity
Organization
Contact information
Practice address
310 S 3RD AVE, WALLA WALLA, WA 99362-3037
(509) 529-3762
(509) 529-7622
Mailing address
310 S 3RD AVE, WALLA WALLA, WA 99362-3037
(509) 529-3762
(509) 529-7622
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE00004263
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0028263
STATE LABOR & INDUSTRIES
WA
05
—
5347000
—
WA
Enumeration date
12/13/2006
Last updated
09/25/2008
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