Provider Demographics
NPI:1831264795
Name:CESSNA, ROBERT S (DMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:CESSNA
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:PO BOX 60
Mailing Address - Street 2:305 LIBERTY ST
Mailing Address - City:PERRYOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15473
Mailing Address - Country:US
Mailing Address - Phone:724-736-2300
Mailing Address - Fax:724-736-1821
Practice Address - Street 1:305 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:PERRYOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15473
Practice Address - Country:US
Practice Address - Phone:724-736-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030870L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice