Provider Demographics
NPI:1346329364
Name:DESIPIO, ROBERT FRANCIS JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:DESIPIO
Suffix:JR
Gender:M
Credentials:DMD
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 135
Mailing Address - Street 2:
Mailing Address - City:ZEPHYR COVE
Mailing Address - State:NV
Mailing Address - Zip Code:89448-0135
Mailing Address - Country:US
Mailing Address - Phone:610-220-3871
Mailing Address - Fax:
Practice Address - Street 1:120 MCFAUL WAY
Practice Address - Street 2:
Practice Address - City:ZEPHYR COVE
Practice Address - State:NV
Practice Address - Zip Code:89448-9807
Practice Address - Country:US
Practice Address - Phone:775-588-5183
Practice Address - Fax:775-364-1744
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0189951223G0001X
PADS028949L1223G0001X
NV74001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice