Provider Demographics
NPI:1477767317
Name:SERAFIN, ROBERT BERNARD JR (DMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BERNARD
Last Name:SERAFIN
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 1:542 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013
Mailing Address - Country:US
Mailing Address - Phone:717-243-3335
Mailing Address - Fax:717-243-7158
Practice Address - Street 1:542 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013
Practice Address - Country:US
Practice Address - Phone:717-243-3335
Practice Address - Fax:717-243-7158
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035232L122300000X
PADS0352321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist