Provider Demographics
NPI:1619108966
Name:VARNER, ROBERT EARL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EARL
Last Name:VARNER
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 1:1729 W HARVARD AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2788
Mailing Address - Country:US
Mailing Address - Phone:541-673-0924
Mailing Address - Fax:541-673-0925
Practice Address - Street 1:1729 W HARVARD AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2788
Practice Address - Country:US
Practice Address - Phone:541-673-0924
Practice Address - Fax:541-673-0925
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR44691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics