Provider Demographics
NPI:1225099906
Name:IOPPOLO, ROBERT BRYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRYAN
Last Name:IOPPOLO
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 1:4211 85TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1931
Mailing Address - Country:US
Mailing Address - Phone:806-783-8837
Mailing Address - Fax:806-783-8841
Practice Address - Street 1:4211 85TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1931
Practice Address - Country:US
Practice Address - Phone:806-783-8837
Practice Address - Fax:806-783-8841
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery