Provider Demographics
NPI:1215019906
Name:FOSTER, ROBERT J
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 CROSS ROADS PLZ
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2288
Mailing Address - Country:US
Mailing Address - Phone:724-547-0690
Mailing Address - Fax:724-547-1918
Practice Address - Street 1:272 CROSS ROADS PLZ
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2288
Practice Address - Country:US
Practice Address - Phone:724-547-0690
Practice Address - Fax:724-547-1918
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA22285L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice