Provider Demographics
NPI:1437298981
Name:KRAVECS, ROBERT A JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:KRAVECS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 BLACK ROCK TPKE STE 207
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3546
Mailing Address - Country:US
Mailing Address - Phone:203-335-8830
Mailing Address - Fax:203-336-9213
Practice Address - Street 1:1817 BLACK ROCK TPKE STE 207
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3546
Practice Address - Country:US
Practice Address - Phone:203-335-8830
Practice Address - Fax:203-336-9213
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT59991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice