Provider Demographics
NPI:1912077611
Name:UNDERKOFLER, ROBERT J JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:UNDERKOFLER
Suffix:JR
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 1:3301 SW 34TH CIR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6621
Mailing Address - Country:US
Mailing Address - Phone:352-237-5744
Mailing Address - Fax:352-237-5799
Practice Address - Street 1:3301 SW 34TH CIR
Practice Address - Street 2:SUITE 204
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6621
Practice Address - Country:US
Practice Address - Phone:352-237-5744
Practice Address - Fax:352-237-5799
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN104011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice