Provider Demographics
NPI:1881784940
Name:DAYSE, ROBERT S (DDS, MBA)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:DAYSE
Suffix:
Gender:M
Credentials:DDS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 EVIAN CT
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1152
Mailing Address - Country:US
Mailing Address - Phone:301-633-6535
Mailing Address - Fax:
Practice Address - Street 1:2340 EVIAN CT
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1152
Practice Address - Country:US
Practice Address - Phone:301-633-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10006681223S0112X
MD141391223S0112X
VA04014129631223S0112X
NY052925-11223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery