Provider Demographics
NPI:1639220015
Name:OBREGON, ROBERT PALMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PALMER
Last Name:OBREGON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 SUNRISE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7803
Mailing Address - Country:US
Mailing Address - Phone:916-967-7721
Mailing Address - Fax:916-967-2820
Practice Address - Street 1:5414 SUNRISE BLVD STE F
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7803
Practice Address - Country:US
Practice Address - Phone:916-967-7721
Practice Address - Fax:916-967-2820
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0355291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice