Provider Demographics
NPI:1275694754
Name:DEAN, ROBERT DANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DANA
Last Name:DEAN
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 1:411 STRANDER BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2924
Mailing Address - Country:US
Mailing Address - Phone:206-575-3326
Mailing Address - Fax:206-575-3349
Practice Address - Street 1:411 STRANDER BLVD
Practice Address - Street 2:STE 204
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2924
Practice Address - Country:US
Practice Address - Phone:206-575-3326
Practice Address - Fax:206-575-3349
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00005408122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist