Provider Demographics
NPI:1154449494
Name:GEAR, ROBERT DALE SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DALE
Last Name:GEAR
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 CORPORATE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3506
Mailing Address - Country:US
Mailing Address - Phone:239-482-5311
Mailing Address - Fax:239-482-8531
Practice Address - Street 1:6323 CORPORATE CT
Practice Address - Street 2:SUITE A
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3506
Practice Address - Country:US
Practice Address - Phone:239-482-5311
Practice Address - Fax:239-482-8531
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00053761223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55298Medicare UPIN