Provider Demographics
NPI:1083616551
Name:WOOLERY, ROBERT LELAND (D D S)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LELAND
Last Name:WOOLERY
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:ROBERT L.
Other - Middle Name:L
Other - Last Name:WOOLERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:D D S
Mailing Address - Street 1:1110 DRIFTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-1812
Mailing Address - Country:US
Mailing Address - Phone:831-262-1020
Mailing Address - Fax:
Practice Address - Street 1:1110 DRIFTWOOD PL
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-1812
Practice Address - Country:US
Practice Address - Phone:831-262-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice