Provider Demographics
NPI:1629071436
Name:OVERCASH, ROBERT F JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:OVERCASH
Suffix:JR
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 1:229 N 1ST ST
Mailing Address - Street 2:PO BOX 867
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-3902
Mailing Address - Country:US
Mailing Address - Phone:704-982-5811
Mailing Address - Fax:704-982-5686
Practice Address - Street 1:229 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3902
Practice Address - Country:US
Practice Address - Phone:704-982-5811
Practice Address - Fax:704-982-5686
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3816122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU40168Medicare UPIN