Provider Demographics
NPI:1144426115
Name:TROSVIG, ROBERT A
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:TROSVIG
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:ALVIN
Other - Last Name:TROSVIG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1620 SILVER LK RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208
Mailing Address - Country:US
Mailing Address - Phone:425-338-3053
Mailing Address - Fax:
Practice Address - Street 1:9800 HARBOUR PL
Practice Address - Street 2:#203
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-4749
Practice Address - Country:US
Practice Address - Phone:425-493-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA37431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice