Provider Demographics
NPI:1215004932
Name:LEVINE, ROBERT H (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:LEVINE
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:PO BOX 461
Mailing Address - Street 2:256 COLUMBIA TPK NORTH TOWER STE 213
Mailing Address - City:FLORHAM PARKS
Mailing Address - State:NJ
Mailing Address - Zip Code:07932
Mailing Address - Country:US
Mailing Address - Phone:973-377-6300
Mailing Address - Fax:973-822-1098
Practice Address - Street 1:256 COLUMBIA TPK
Practice Address - Street 2:NORTH TOWER STE 213
Practice Address - City:FLORHAM PARKS
Practice Address - State:NJ
Practice Address - Zip Code:07932
Practice Address - Country:US
Practice Address - Phone:973-377-6300
Practice Address - Fax:973-822-1098
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100771700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist