Provider Demographics
NPI:1124166673
Name:KANE, ROBERT BRUCE (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRUCE
Last Name:KANE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 ROUTE 37 W
Mailing Address - Street 2:SUITE C-4
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4973
Mailing Address - Country:US
Mailing Address - Phone:732-244-3800
Mailing Address - Fax:732-244-5081
Practice Address - Street 1:1163 ROUTE 37 W
Practice Address - Street 2:SUITE C-4
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4973
Practice Address - Country:US
Practice Address - Phone:732-244-3800
Practice Address - Fax:732-244-5081
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI156711223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics