Provider Demographics
NPI:1174639470
Name:SLUKA, ROBERT GEORGE (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:GEORGE
Last Name:SLUKA
Suffix:
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 1:1703 CALUMET AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1414
Mailing Address - Country:US
Mailing Address - Phone:219-659-0312
Mailing Address - Fax:
Practice Address - Street 1:1703 CALUMET AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1414
Practice Address - Country:US
Practice Address - Phone:219-659-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007662A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist