Provider Demographics
NPI:1407925050
Name:ROBB, STUART (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:ROBB
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N MCKINLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1327
Mailing Address - Country:US
Mailing Address - Phone:847-295-5854
Mailing Address - Fax:847-295-5854
Practice Address - Street 1:1770 1ST ST
Practice Address - Street 2:SUITE 440
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3200
Practice Address - Country:US
Practice Address - Phone:847-579-4777
Practice Address - Fax:847-579-4785
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X, 122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist