Provider Demographics
NPI:1346451663
Name:REBERT, ROBERT L JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:REBERT
Suffix:JR
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 1:5037 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 3D
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5136
Mailing Address - Country:US
Mailing Address - Phone:504-885-7510
Mailing Address - Fax:
Practice Address - Street 1:5037 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 3D
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-5136
Practice Address - Country:US
Practice Address - Phone:504-885-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3021122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist