MEDICARE: ROBERT M. SANDER, D.D.S., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	3014858	OH

General Provider Information

NPI Number	:	1801884135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT M. SANDER, D.D.S., INC.

Provider Business Mailing Address
First Line	:	3012 GLENMORE AVE
Second Line	:	SUITE 107
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2269
Country	:	US
Telephone Number	:	513-661-4051
Fax Number	:	513-661-4052

Provider Business Practice Location Address
First Line	:	3012 GLENMORE AVE
Second Line	:	SUITE 107
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2269
Country	:	US
Telephone Number	:	513-661-4051
Fax Number	:	513-661-4052

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT M. SANDER
Credential	:	D.D.S.
Telephone Number	:	513-661-4051

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	10/23/2007

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