Provider Demographics
NPI:1811153455
Name:INFELD, ROBERT SAUL (DMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SAUL
Last Name:INFELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22612 N 55TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-7166
Mailing Address - Country:US
Mailing Address - Phone:602-469-2818
Mailing Address - Fax:
Practice Address - Street 1:13375 W. GRAND AVE..
Practice Address - Street 2:109
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7707
Practice Address - Country:US
Practice Address - Phone:623-544-2300
Practice Address - Fax:623-544-2704
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2607122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist