Provider Demographics
NPI:1609293471
Name:ROBERT S. FLORES DMD, INC
Entity Type:Organization
Organization Name:ROBERT S. FLORES DMD, INC
Other - Org Name:R & R DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:805-544-9440
Mailing Address - Street 1:878 BOYSEN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405
Mailing Address - Country:US
Mailing Address - Phone:805-544-9440
Mailing Address - Fax:805-544-9458
Practice Address - Street 1:878 BOYSEN AVENUE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405
Practice Address - Country:US
Practice Address - Phone:805-544-9440
Practice Address - Fax:805-544-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA575731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty