Provider Demographics
NPI:1699892836
Name:CANDLER, ROBERT ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:CANDLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:SUITE 116 JANAF OFFICE BLDG
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-461-8173
Mailing Address - Fax:757-466-0227
Practice Address - Street 1:5900 E VIRGINIA BEACH BLVD
Practice Address - Street 2:SUITE 116 JANAF OFFICE BLDG
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-461-8173
Practice Address - Fax:757-466-0227
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010063001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice