Provider Demographics
NPI:1740318096
Name:HURLEY, ROBERT BRUCE JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRUCE
Last Name:HURLEY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:118 S GREENVILLE WEST DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-3554
Mailing Address - Country:US
Mailing Address - Phone:616-754-9195
Mailing Address - Fax:616-754-7329
Practice Address - Street 1:118 S GREENVILLE WEST DR
Practice Address - Street 2:SUITE 1
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-3554
Practice Address - Country:US
Practice Address - Phone:616-754-9195
Practice Address - Fax:616-754-7329
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI12OtherDENTIST