Healthcare Provider Details

I. General information

NPI: 1053579458
Provider Name (Legal Business Name): ROBERT W. EISBERG II, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 08/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 TIMBER DR
GARNER NC
27529-2571
US

IV. Provider business mailing address

2630 TIMBER DR
GARNER NC
27529-2571
US

V. Phone/Fax

Practice location:
  • Phone: 919-878-1810
  • Fax: 919-878-1840
Mailing address:
  • Phone: 919-878-1810
  • Fax: 919-878-1840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8267
License Number StateNC

VIII. Authorized Official

Name: DR. ROBERT WILLIAM EISBERG II
Title or Position: PRESIDENT/OWNER
Credential: DDS
Phone: 919-878-1810