Provider Demographics
NPI:1104878479
Name:ROBE, RALPH STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:STANLEY
Last Name:ROBE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 W NATIONAL AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-9521
Mailing Address - Country:US
Mailing Address - Phone:262-796-9900
Mailing Address - Fax:262-796-5102
Practice Address - Street 1:13700 W NATIONAL AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-9521
Practice Address - Country:US
Practice Address - Phone:262-796-9900
Practice Address - Fax:262-796-5102
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2636015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist