Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 10907 | NJ |
NPI | 1083786677 |
---|---|
Provider Name | Dr. Robert Evan Spiegel |
First Address | Bloomfield, NJ 07003-5552 |
Second Address | Bloomfield, NJ 07003-5552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |