Individual
DR. ROBERT PATRICK SEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12000 STONE LAKE RD, DULCE, NM 87528
(505) 759-7211
Mailing address
12000 STONE LAKE ROAD, DULCE, NM 87528
(505) 759-7211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7937
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
11/09/2006
Last updated
05/27/2008
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