Provider Demographics
NPI:1396882502
Name:KASPER, ROBERT PAUL (DMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:KASPER
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 1:3000 N LITCHFIELD RD STE 110
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7802
Mailing Address - Country:US
Mailing Address - Phone:623-873-2777
Mailing Address - Fax:623-873-0962
Practice Address - Street 1:3000 N LITCHFIELD RD STE 110
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7802
Practice Address - Country:US
Practice Address - Phone:623-873-2777
Practice Address - Fax:623-873-0962
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice