Provider Demographics
NPI:1730134388
Name:ROBERT E. MOUNT, JR., D.D.S. P.A.
Entity Type:Organization
Organization Name:ROBERT E. MOUNT, JR., D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-493-1416
Mailing Address - Street 1:110 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHIEFLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32626-0901
Mailing Address - Country:US
Mailing Address - Phone:352-493-1416
Mailing Address - Fax:352-490-2057
Practice Address - Street 1:110 E PARK AVE
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-0901
Practice Address - Country:US
Practice Address - Phone:352-493-1416
Practice Address - Fax:352-490-2057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty