Provider Demographics
NPI:1306058870
Name:GRABER, ROBERT CERIS (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CERIS
Last Name:GRABER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1564
Mailing Address - Country:US
Mailing Address - Phone:201-438-2373
Mailing Address - Fax:201-438-5875
Practice Address - Street 1:135 UNION AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1564
Practice Address - Country:US
Practice Address - Phone:201-438-2373
Practice Address - Fax:201-438-5875
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01273300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist