Provider Demographics
NPI:1710106752
Name:LARNER, ROBERT C (DDS, DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:LARNER
Suffix:
Gender:M
Credentials:DDS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 E OCEAN FRONT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92661
Mailing Address - Country:US
Mailing Address - Phone:949-646-4439
Mailing Address - Fax:
Practice Address - Street 1:2121 E. COAST HIGHWAY
Practice Address - Street 2:SUITE 140
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625
Practice Address - Country:US
Practice Address - Phone:949-640-0222
Practice Address - Fax:949-640-0333
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16567122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics