Provider Demographics
NPI:1235398181
Name:HARTER, ROBERT L (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:HARTER
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 1:18224 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3306
Mailing Address - Country:US
Mailing Address - Phone:216-226-3880
Mailing Address - Fax:216-226-2030
Practice Address - Street 1:18224 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3306
Practice Address - Country:US
Practice Address - Phone:216-226-3880
Practice Address - Fax:216-226-2030
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist