Provider Demographics
NPI:1013046101
Name:EFFREN, ROBERT TAYLOR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TAYLOR
Last Name:EFFREN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8914
Mailing Address - Country:US
Mailing Address - Phone:954-752-4408
Mailing Address - Fax:954-752-0980
Practice Address - Street 1:1500 N UNIVERSITY DR
Practice Address - Street 2:SUITE 111
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8914
Practice Address - Country:US
Practice Address - Phone:954-752-4408
Practice Address - Fax:954-752-0980
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45641223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics