MEDICARE: DR. ROBERT JAMES PRIJATEL DDS

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	1223G0001X	General Practice Dentistry	16664	OH

General Provider Information

NPI Number	:	1265603450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JAMES PRIJATEL DDS

Provider Business Mailing Address
First Line	:	2794 SOM CENTER RD
Second Line	:	#07
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-8491
Country	:	US
Telephone Number	:	440-944-7745
Fax Number	:	440-944-7745

Provider Business Practice Location Address
First Line	:	2794 SOM CENTER RD
Second Line	:	#07
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-8491
Country	:	US
Telephone Number	:	440-944-7745
Fax Number	:	440-944-7745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2008
Last Update Date	:	03/17/2008

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