Provider Demographics
NPI:1598842346
Name:DOYLE, ROBERT ALLEN JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALLEN
Last Name:DOYLE
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 1:2700 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1158
Mailing Address - Country:US
Mailing Address - Phone:740-264-6811
Mailing Address - Fax:740-264-6812
Practice Address - Street 1:2700 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1158
Practice Address - Country:US
Practice Address - Phone:740-264-6811
Practice Address - Fax:740-264-6812
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0356931223G0001X
OH023979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0137754Medicaid
PA103036064 0001Medicaid