Provider Demographics
NPI:1013040765
Name:JUHNKE, ROBERT LLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LLOYD
Last Name:JUHNKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 ST. CLAIR AVE
Mailing Address - Street 2:STE 9
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105
Mailing Address - Country:US
Mailing Address - Phone:651-690-2837
Mailing Address - Fax:
Practice Address - Street 1:1337 ST. CLAIR AVE
Practice Address - Street 2:STE 9
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105
Practice Address - Country:US
Practice Address - Phone:651-690-2837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist