Provider Demographics
NPI:1841525516
Name:OBRADOVICH, ROBERT N (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:OBRADOVICH
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 1:4430 STATE ROUTE 66
Mailing Address - Street 2:SUITE 1
Mailing Address - City:APOLLO
Mailing Address - State:PA
Mailing Address - Zip Code:15613-2015
Mailing Address - Country:US
Mailing Address - Phone:724-727-3471
Mailing Address - Fax:724-727-2316
Practice Address - Street 1:4430 STATE ROUTE 66
Practice Address - Street 2:
Practice Address - City:APOLLO
Practice Address - State:PA
Practice Address - Zip Code:15613-2015
Practice Address - Country:US
Practice Address - Phone:724-727-3471
Practice Address - Fax:724-727-2316
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023686-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist