Provider Demographics
NPI:1730305301
Name:DR. ROBERT M FARBER DDS PC
Entity Type:Organization
Organization Name:DR. ROBERT M FARBER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-562-5610
Mailing Address - Street 1:23919 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1207
Mailing Address - Country:US
Mailing Address - Phone:313-562-5610
Mailing Address - Fax:313-562-1507
Practice Address - Street 1:23919 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1207
Practice Address - Country:US
Practice Address - Phone:313-562-5610
Practice Address - Fax:313-562-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty