Provider Demographics
NPI:1932268133
Name:GUY, ROBERT CAMPBELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CAMPBELL
Last Name:GUY
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 1:689 STOCKFORD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1460
Mailing Address - Country:US
Mailing Address - Phone:517-263-1707
Mailing Address - Fax:517-264-5607
Practice Address - Street 1:689 STOCKFORD DRIVE
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1460
Practice Address - Country:US
Practice Address - Phone:517-263-1707
Practice Address - Fax:517-264-5607
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI10675122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4034651Medicaid