Provider Demographics
NPI:1780833640
Name:DR. ROBERT N. NAU, DDS, FAGD, LLC
Entity Type:Organization
Organization Name:DR. ROBERT N. NAU, DDS, FAGD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:NITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-486-2902
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:202 S WHITCOMB AVE.
Mailing Address - City:TONASKET
Mailing Address - State:WA
Mailing Address - Zip Code:98855-0728
Mailing Address - Country:US
Mailing Address - Phone:509-486-2902
Mailing Address - Fax:509-486-2904
Practice Address - Street 1:202 SOUTH WHITCOMB AVE
Practice Address - Street 2:
Practice Address - City:TONASKET
Practice Address - State:WA
Practice Address - Zip Code:98855
Practice Address - Country:US
Practice Address - Phone:509-486-2902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000057411223G0001X
WADE000111201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE00005741OtherWA STATE LICENSE NUMBER
WADE00011120OtherDR. STINSON STATE LICENSE
WA1235202672OtherTYPE 1-NPI
WA1417144866OtherNPI TYPE1-DR. STEPHANIE STINSON