Provider Demographics
NPI:1851949655
Name:ROBERT J NOTARI DMD PC
Entity Type:Organization
Organization Name:ROBERT J NOTARI DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOTARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-451-0130
Mailing Address - Street 1:429 S MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1684
Mailing Address - Country:US
Mailing Address - Phone:570-451-0130
Mailing Address - Fax:
Practice Address - Street 1:429 S MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518-1684
Practice Address - Country:US
Practice Address - Phone:570-451-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty