Organization
DR. RICHARD J. SUNDBERG D.D.S., P.S.
Active
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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