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General NPI Number Information
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NPI Number | 1700903671
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Entity Type | Individual
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Provider Name | ROBERT EDWARD LEVENS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 8605 MONTAGUE LN
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City | MYRTLE BEACH
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State | SC
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Zip | 29588-4504
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Country | US
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Telephone | 843-650-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 2 WOODHUE CT
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City | LUFKIN
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State | TX
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Zip | 75904-4318
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Country | US
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Telephone | 936-240-3365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10690
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16977
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9267
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License Number State | CO
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