Berquist, Robert Jordan

Berquist, Robert Jordan is an sole proprietor health care provider with primary practice located at 1444 119Th St , Whiting IN 46394-1760. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Berquist, Robert Jordan can be contacted via phone (219) 659-1530.

Contact Information

Primary practice address
1444 119Th St Whiting IN 46394-1760
Fax: (219) 659-1532
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 12009702A Indiana

Profile Details

NPI number 1619187507
LBN Legal business name Berquist, Robert Jordan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 22nd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619187507 NPPES
Indiana Other 12009702A DENTAL LICENSE

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