Provider Demographics
NPI:1750734521
Name:HUEY, ROBERT FRANKLIN (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANKLIN
Last Name:HUEY
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 1:204 SIERRA PT
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-1347
Mailing Address - Country:US
Mailing Address - Phone:217-714-4304
Mailing Address - Fax:
Practice Address - Street 1:3429 NAMEOKI RD
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-3709
Practice Address - Country:US
Practice Address - Phone:618-452-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist