Provider Demographics
NPI:1588777452
Name:HULT, ROBERT JOHN JR (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:HULT
Suffix:JR
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 1:8 E DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VLG
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3919
Mailing Address - Country:US
Mailing Address - Phone:847-439-9440
Mailing Address - Fax:847-439-8837
Practice Address - Street 1:8 E DEVON AVE
Practice Address - Street 2:
Practice Address - City:ELK GROVE VLG
Practice Address - State:IL
Practice Address - Zip Code:60007-3919
Practice Address - Country:US
Practice Address - Phone:847-439-9440
Practice Address - Fax:847-439-8837
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist