Provider Demographics
NPI:1902940406
Name:ROBERT A. FOSS, DDS, INC.
Entity Type:Organization
Organization Name:ROBERT A. FOSS, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:FOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-282-4195
Mailing Address - Street 1:100 E HUNTINGTON DR STE 211
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1022
Mailing Address - Country:US
Mailing Address - Phone:626-282-4195
Mailing Address - Fax:626-282-6770
Practice Address - Street 1:100 E HUNTINGTON DR STE 211
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-1022
Practice Address - Country:US
Practice Address - Phone:626-282-4195
Practice Address - Fax:626-282-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty