MEDICARE: ROBERT A . POLLARA,DDS,PA

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	1223P0300X	Periodontics	8740	NJ

General Provider Information

NPI Number	:	1134339054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT A . POLLARA,DDS,PA

Provider Business Mailing Address
First Line	:	110 MADISON AVE
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6013
Country	:	US
Telephone Number	:	973-267-7011
Fax Number	:	973-267-7011

Provider Business Practice Location Address
First Line	:	110 MADISON AVE
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6013
Country	:	US
Telephone Number	:	973-267-7011
Fax Number	:	973-267-7011

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT ALFRED POLLARA
Credential	:	DDS
Telephone Number	:	973-267-7011

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/24/2007

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