Provider Demographics
NPI:1346376811
Name:ROONEY, ROBERT JOHN II (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:ROONEY
Suffix:II
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 1:100 SMART PLACE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1234
Mailing Address - Country:US
Mailing Address - Phone:985-641-6607
Mailing Address - Fax:985-641-3070
Practice Address - Street 1:100 SMART PL
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2040
Practice Address - Country:US
Practice Address - Phone:985-641-6607
Practice Address - Fax:985-641-3070
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45101223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice