Provider Demographics
NPI:1407040306
Name:DI SALVO, ROBERT J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:DI SALVO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:301 KEARNY AVE
Mailing Address - Street 2:FOR ALL CHILDREN & ADULT DENTISTRY
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2522
Mailing Address - Country:US
Mailing Address - Phone:973-769-4897
Mailing Address - Fax:201-955-3210
Practice Address - Street 1:301 KEARNY AVE
Practice Address - Street 2:FOR ALL CHILDREN & ADULT DENTISTRY
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2522
Practice Address - Country:US
Practice Address - Phone:973-769-4897
Practice Address - Fax:201-955-3210
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ22DI00930603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist