Provider Demographics
NPI:1740339720
Name:COMINI, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:COMINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 S BELSAY RD STE A
Mailing Address - Street 2:P.O. BOX 90459
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1909
Mailing Address - Country:US
Mailing Address - Phone:810-744-0433
Mailing Address - Fax:810-744-2257
Practice Address - Street 1:1140 S BELSAY RD STE A
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1909
Practice Address - Country:US
Practice Address - Phone:810-744-0433
Practice Address - Fax:810-744-2257
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010143911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice