Provider Demographics
NPI:1437242740
Name:SLABY, ROBERT THEODORE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:THEODORE
Last Name:SLABY
Suffix:
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 1:27445 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3411
Mailing Address - Country:US
Mailing Address - Phone:248-559-4088
Mailing Address - Fax:248-559-1398
Practice Address - Street 1:27445 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-3411
Practice Address - Country:US
Practice Address - Phone:248-559-4088
Practice Address - Fax:248-559-1398
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010132301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice