Provider Demographics
NPI:1265603450
Name:PRIJATEL, ROBERT JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:PRIJATEL
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 1:2794 SOM CENTER RD
Mailing Address - Street 2:#07
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8491
Mailing Address - Country:US
Mailing Address - Phone:440-944-7745
Mailing Address - Fax:440-944-7745
Practice Address - Street 1:2794 SOM CENTER RD
Practice Address - Street 2:#07
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-8491
Practice Address - Country:US
Practice Address - Phone:440-944-7745
Practice Address - Fax:440-944-7745
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH166641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice