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General NPI Number Information
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NPI Number | 1285852657
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Entity Type | Organization
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Legal Business Name | ROBERT J. EISENBERG DDS PA
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 951 NW 13TH ST STE 3A
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City | BOCA RATON
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State | FL
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Zip | 33486-2337
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Country | US
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Telephone | 561-271-7093
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Fax |
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Provider Business Mailing Address
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Address Line | 20979 OLIVO WAY
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City | BOCA RATON
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State | FL
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Zip | 33433-1613
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Country | US
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Telephone | 561-271-7093
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT J. EISENBERG
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Credential | DDS
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Telephone | 561-271-7093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN7240
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License Number State | FL
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