Provider Demographics
NPI:1356592349
Name:BRONECKI, ROBERT ALLAN (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALLAN
Last Name:BRONECKI
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:PO BOX 20161
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-0161
Mailing Address - Country:US
Mailing Address - Phone:406-699-1992
Mailing Address - Fax:406-259-2082
Practice Address - Street 1:926 MAIN ST STE 23
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3359
Practice Address - Country:US
Practice Address - Phone:406-252-1852
Practice Address - Fax:406-259-2082
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice