Provider Demographics
NPI:1558427047
Name:STURKEY, ROBERT LARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LARRY
Last Name:STURKEY
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 1:1000 S CLEVELAND MASSILLON RD
Mailing Address - Street 2:STE 14
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-9242
Mailing Address - Country:US
Mailing Address - Phone:330-670-6364
Mailing Address - Fax:330-670-1327
Practice Address - Street 1:1000 S CLEVELAND MASSILLON RD
Practice Address - Street 2:STE 14
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-9242
Practice Address - Country:US
Practice Address - Phone:330-670-6364
Practice Address - Fax:330-670-1327
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice