Provider Demographics
NPI:1912073263
Name:ROBERT A OAK DDS LTD
Entity Type:Organization
Organization Name:ROBERT A OAK DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:OAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-749-2607
Mailing Address - Street 1:229 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191
Mailing Address - Country:US
Mailing Address - Phone:708-484-7691
Mailing Address - Fax:
Practice Address - Street 1:6903 CERMAK RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402
Practice Address - Country:US
Practice Address - Phone:708-749-2607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A107741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty