Provider Demographics
NPI:1033447651
Name:ROBERT ARMSTRONG DDS FAGD PC
Entity Type:Organization
Organization Name:ROBERT ARMSTRONG DDS FAGD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-627-7172
Mailing Address - Street 1:104 DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-1312
Mailing Address - Country:US
Mailing Address - Phone:231-627-7172
Mailing Address - Fax:231-627-1101
Practice Address - Street 1:104 DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1312
Practice Address - Country:US
Practice Address - Phone:231-627-7172
Practice Address - Fax:231-627-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901014934261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI12 2605840Medicaid
MI1144225574OtherNPI
MI1144225574OtherNPI