Provider Demographics
NPI:1740326966
Name:RECHTIEN, ROBERT W JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:RECHTIEN
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 1:6712 N OAK TRFY
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3345
Mailing Address - Country:US
Mailing Address - Phone:816-436-1785
Mailing Address - Fax:816-436-2811
Practice Address - Street 1:6712 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-3345
Practice Address - Country:US
Practice Address - Phone:816-436-1785
Practice Address - Fax:816-436-2811
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODEN0153001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice