Provider Demographics
NPI:1215177472
Name:ENGLE, ROBERT K (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:ENGLE
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 1:517 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:MO
Mailing Address - Zip Code:64020-2502
Mailing Address - Country:US
Mailing Address - Phone:660-463-2222
Mailing Address - Fax:
Practice Address - Street 1:517 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:MO
Practice Address - Zip Code:64020-2502
Practice Address - Country:US
Practice Address - Phone:660-463-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO137321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice