Provider Demographics
NPI:1174801617
Name:LEVY, ROBERT HARRY (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HARRY
Last Name:LEVY
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 1:828 HARWOOD RD
Mailing Address - Street 2:TARRANT COUNTY COLLEGE DENTAL HYGIENE PROGRAM
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054
Mailing Address - Country:US
Mailing Address - Phone:214-515-6325
Mailing Address - Fax:214-515-6700
Practice Address - Street 1:828 HARWOOD RD
Practice Address - Street 2:TARRANT COUNTY COLLEGE DENTAL HYGIENE PROGRAM
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054
Practice Address - Country:US
Practice Address - Phone:817-515-6325
Practice Address - Fax:817-515-6700
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice