Provider Demographics
NPI:1114947884
Name:VAN ESS, ROBERT SCOTT (DMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:VAN ESS
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 1:420 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17737-1630
Mailing Address - Country:US
Mailing Address - Phone:570-584-3686
Mailing Address - Fax:570-584-6424
Practice Address - Street 1:420 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HUGHESVILLE
Practice Address - State:PA
Practice Address - Zip Code:17737-1630
Practice Address - Country:US
Practice Address - Phone:570-584-3686
Practice Address - Fax:570-584-6424
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025515L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice