Provider Demographics
NPI:1285731174
Name:ATOL, ROBERT C (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:ATOL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1053 COLORADO BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2572
Mailing Address - Country:US
Mailing Address - Phone:323-257-9361
Mailing Address - Fax:323-257-0509
Practice Address - Street 1:1053 COLORADO BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2572
Practice Address - Country:US
Practice Address - Phone:323-257-9361
Practice Address - Fax:323-257-0509
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA164621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice