Provider Demographics
NPI:1639391220
Name:ROBERT H. DOTY D.D.S. ASSOCIATES INC.
Entity Type:Organization
Organization Name:ROBERT H. DOTY D.D.S. ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HARLIN
Authorized Official - Last Name:DOTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-225-0105
Mailing Address - Street 1:4313 REGAL AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-2978
Mailing Address - Country:US
Mailing Address - Phone:330-225-0105
Mailing Address - Fax:
Practice Address - Street 1:4313 REGAL AVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-2978
Practice Address - Country:US
Practice Address - Phone:330-225-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty