Provider Demographics
NPI:1952465577
Name:ROMEO, ROBERT LEWIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEWIS
Last Name:ROMEO
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 1:4929 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-1304
Mailing Address - Country:US
Mailing Address - Phone:814-838-4636
Mailing Address - Fax:
Practice Address - Street 1:2634 W 30TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3172
Practice Address - Country:US
Practice Address - Phone:814-833-0282
Practice Address - Fax:814-836-0608
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022128-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice