Provider Demographics
NPI:1215146147
Name:ZAVADA, ROBERT BART (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BART
Last Name:ZAVADA
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 1:1056 GOODLETTE RD N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5488
Mailing Address - Country:US
Mailing Address - Phone:239-435-0200
Mailing Address - Fax:
Practice Address - Street 1:1056 GOODLETTE RD N
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5488
Practice Address - Country:US
Practice Address - Phone:239-435-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 11900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist