Provider Demographics
NPI:1215427844
Name:HUOT, ROBERT WILL (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILL
Last Name:HUOT
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 1:8100 PENN AVE S STE 172
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1325
Mailing Address - Country:US
Mailing Address - Phone:952-884-8337
Mailing Address - Fax:
Practice Address - Street 1:8100 PENN AVE S STE 172
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1325
Practice Address - Country:US
Practice Address - Phone:952-884-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND140201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice