Provider Demographics
NPI:1255510301
Name:HYLAND, ROBERT ALLEN (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALLEN
Last Name:HYLAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4291 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-4051
Mailing Address - Country:US
Mailing Address - Phone:989-793-0899
Mailing Address - Fax:
Practice Address - Street 1:4291 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4051
Practice Address - Country:US
Practice Address - Phone:989-793-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0145341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice