Provider Demographics
NPI:1801881099
Name:LEFKOWITZ, ROBERT D (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:LEFKOWITZ
Suffix:
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 1:2417 MCGUIRE BLVD
Mailing Address - Street 2:305TH DENTAL SQUADRON
Mailing Address - City:MC GUIRE AFB
Mailing Address - State:NJ
Mailing Address - Zip Code:08641-5118
Mailing Address - Country:US
Mailing Address - Phone:609-754-3786
Mailing Address - Fax:
Practice Address - Street 1:2417 MCGUIRE BLVD
Practice Address - Street 2:305TH DENTAL SQUADRON
Practice Address - City:MC GUIRE AFB
Practice Address - State:NJ
Practice Address - Zip Code:08641-5118
Practice Address - Country:US
Practice Address - Phone:609-754-3786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI14489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist