Provider Demographics
NPI:1801295324
Name:ROBERT GEMMELL D.M.D., P.C
Entity type:Organization
Organization Name:ROBERT GEMMELL D.M.D., P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GEMMELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PC
Authorized Official - Phone:541-689-1287
Mailing Address - Street 1:1775 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2642
Mailing Address - Country:US
Mailing Address - Phone:541-689-1287
Mailing Address - Fax:541-689-1260
Practice Address - Street 1:1775 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-2642
Practice Address - Country:US
Practice Address - Phone:541-689-1287
Practice Address - Fax:541-689-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD6886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty