MEDICARE: DR. ROBERT A KRAVECS JR. D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5999	CT

General Provider Information

NPI Number	:	1437298981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A KRAVECS JR. D.M.D.

Provider Business Mailing Address
First Line	:	1817 BLACK ROCK TPKE STE 207
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3546
Country	:	US
Telephone Number	:	203-335-8830
Fax Number	:	203-336-9213

Provider Business Practice Location Address
First Line	:	1817 BLACK ROCK TPKE STE 207
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3546
Country	:	US
Telephone Number	:	203-335-8830
Fax Number	:	203-336-9213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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