Provider Demographics
NPI:1619122579
Name:DUTKA, ROBERT F (ROBERT DUTKA DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:DUTKA
Suffix:
Gender:M
Credentials:ROBERT DUTKA DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5301
Mailing Address - Country:US
Mailing Address - Phone:847-577-4444
Mailing Address - Fax:847-577-4463
Practice Address - Street 1:615 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5301
Practice Address - Country:US
Practice Address - Phone:847-577-4444
Practice Address - Fax:847-577-4463
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA13591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist