MEDICARE: ROBERT L. LERNER D.D.S

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	261Q00000X	Clinic/Center	851

General Provider Information

NPI Number	:	1447523774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT L. LERNER D.D.S

Provider Business Mailing Address
First Line	:	9500 INDEPENDENCE DR STE 200
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-4617
Country	:	US
Telephone Number	:	907-349-4343
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 INDEPENDENCE DR STE 200
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-4617
Country	:	US
Telephone Number	:	907-349-4343
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT L LERNER
Credential	:	DDS
Telephone Number	:	907-349-4343

Provider Enumeration Date	:	02/16/2012
Last Update Date	:	02/16/2012

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