Provider Demographics
NPI:1295871721
Name:PAGE, ROBERT F (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:PAGE
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 1:535 E 500 S STE C
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-3873
Mailing Address - Country:US
Mailing Address - Phone:801-292-7807
Mailing Address - Fax:801-292-9206
Practice Address - Street 1:535 E 500 S STE C
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-3873
Practice Address - Country:US
Practice Address - Phone:801-292-7807
Practice Address - Fax:801-292-9206
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT533630999221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice