Provider Demographics
NPI:1558538165
Name:LOZUK, ROBERT P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:LOZUK
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 1:620 S MELROSE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6644
Mailing Address - Country:US
Mailing Address - Phone:760-724-2284
Mailing Address - Fax:760-724-8684
Practice Address - Street 1:620 S MELROSE DR STE 200
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6644
Practice Address - Country:US
Practice Address - Phone:760-724-2284
Practice Address - Fax:760-724-8684
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA217291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice