Provider Demographics
NPI:1104984277
Name:MIER, ROBERT WALKER (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WALKER
Last Name:MIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2626 N 76TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-1137
Mailing Address - Country:US
Mailing Address - Phone:414-476-9400
Mailing Address - Fax:414-755-4769
Practice Address - Street 1:2626 N 76TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-1137
Practice Address - Country:US
Practice Address - Phone:414-476-9400
Practice Address - Fax:414-755-4769
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2015-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI1001041-151223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology