Most Relevant Information
Provider Data
| NPI Number: | 1003805748 |
| Provider Name: | ROBERT BRANCA DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 040425 |
Most Important Dates
| Enumeration Date: | 10/16/2005 |
| Last Updated: | 04/02/2015 |
Provider Practice Location
112 ALEXANDER AVE
SUITE A
LAKE GROVE
NY
117550429
Practice Location Phone/Fax
| Phone: | 6312656655 |
| Fax: | 6312659735 |
Provider Mailing Location
112 ALEXANDER AVE
SUITE A
LAKE GROVE
NY
117550429
Provider Mailing Phone/Fax
| Phone: | 6312656655 |
| Fax: | 6312659735 |