Provider Demographics
NPI:1730297219
Name:WOHAR, ROBERT MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:WOHAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 SOUTH GULPH ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3174
Mailing Address - Country:US
Mailing Address - Phone:610-337-7100
Mailing Address - Fax:610-992-0190
Practice Address - Street 1:357 SOUTH GULPH ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3174
Practice Address - Country:US
Practice Address - Phone:610-337-7100
Practice Address - Fax:610-992-0190
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019503L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0048320000OtherKEYSTONE & BLUE SHIELD
D3895OtherAETNA
123458OtherUNITED CONCORDIA
D3895OtherAETNA
123458OtherUNITED CONCORDIA