Provider Demographics
NPI:1467554030
Name:NEMETH, ROBERT B (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:NEMETH
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 1:3131 12TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2219
Mailing Address - Country:US
Mailing Address - Phone:320-253-4981
Mailing Address - Fax:320-253-6268
Practice Address - Street 1:3131 12TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2219
Practice Address - Country:US
Practice Address - Phone:320-253-4981
Practice Address - Fax:320-253-6268
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN77361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics