Provider Demographics
NPI:1952457434
Name:RUMBAUGH, ROBERT L III (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:RUMBAUGH
Suffix:III
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 1:1529 PENNSYLVANIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-1843
Mailing Address - Country:US
Mailing Address - Phone:724-774-5965
Mailing Address - Fax:724-774-5132
Practice Address - Street 1:1529 PENNSYLVANIA AVENUE
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-1843
Practice Address - Country:US
Practice Address - Phone:724-774-5965
Practice Address - Fax:724-774-5132
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025772L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice