Healthcare Provider Details

I. General information

NPI: 1962541862
Provider Name (Legal Business Name): ROBERT G SAYLOR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S BURROWES ST
STATE COLLEGE PA
16801-4008
US

IV. Provider business mailing address

240 S BURROWES ST
STATE COLLEGE PA
16801-4008
US

V. Phone/Fax

Practice location:
  • Phone: 814-238-4400
  • Fax: 814-238-4112
Mailing address:
  • Phone: 814-238-4400
  • Fax: 814-238-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS029151
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier609486
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUNITED CONCORDIA PROVIDER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: