MEDICARE: ROBERT ADLER DDS PC

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	030937	NY

General Provider Information

NPI Number	:	1780855643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT ADLER DDS PC

Provider Business Mailing Address
First Line	:	5824 14 AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4623
Country	:	US
Telephone Number	:	718-438-8400
Fax Number	:	718-438-5292

Provider Business Practice Location Address
First Line	:	5824 14 AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4623
Country	:	US
Telephone Number	:	718-438-8400
Fax Number	:	718-438-5292

Authorized Official
Title or Position	:	PRES
Name	:	DR. ROBERT ADLER
Credential	:	DDS
Telephone Number	:	718-438-8400

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	03/19/2008

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