Provider Demographics
NPI:1568597003
Name:ECKER, ROBERT A (DMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:ECKER
Suffix:
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 1:699 RURAL AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3246
Mailing Address - Country:US
Mailing Address - Phone:570-322-7601
Mailing Address - Fax:570-322-7601
Practice Address - Street 1:699 RURAL AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3246
Practice Address - Country:US
Practice Address - Phone:570-322-7601
Practice Address - Fax:570-322-7601
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021912L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice