Provider Demographics
NPI:1073786919
Name:BENTZ, ROBERT M (DMD, FACP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:BENTZ
Suffix:
Gender:M
Credentials:DMD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1818
Mailing Address - Country:US
Mailing Address - Phone:610-272-6949
Mailing Address - Fax:610-272-8664
Practice Address - Street 1:2601 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1818
Practice Address - Country:US
Practice Address - Phone:610-272-6949
Practice Address - Fax:610-272-8664
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027633L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics