Provider Demographics
NPI:1669692943
Name:CABANAS, ROBERT ANTONIO (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTONIO
Last Name:CABANAS
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 1:11 PEMBERTON ST
Mailing Address - Street 2:
Mailing Address - City:PEMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08068-1111
Mailing Address - Country:US
Mailing Address - Phone:609-726-0341
Mailing Address - Fax:
Practice Address - Street 1:5755 HARTFORD RD
Practice Address - Street 2:FCI FORT DIX
Practice Address - City:FORT DIX
Practice Address - State:NJ
Practice Address - Zip Code:08640
Practice Address - Country:US
Practice Address - Phone:609-723-1100
Practice Address - Fax:609-723-8712
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice