Provider Demographics
NPI:1104827708
Name:ECKELSON, ROBERT ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:ECKELSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:951 NW 13TH ST
Mailing Address - Street 2:STE 3B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2337
Mailing Address - Country:US
Mailing Address - Phone:561-495-8198
Mailing Address - Fax:561-391-6415
Practice Address - Street 1:951 NW 13TH ST
Practice Address - Street 2:#3-B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2337
Practice Address - Country:US
Practice Address - Phone:561-391-6415
Practice Address - Fax:561-391-6415
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2016-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL60011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics