Provider Demographics
NPI:1861591323
Name:EARL, ROBERT RULON (DDS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RULON
Last Name:EARL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 WEST SAHARA AVE. STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0375
Mailing Address - Country:US
Mailing Address - Phone:702-871-4990
Mailing Address - Fax:702-871-9853
Practice Address - Street 1:5320 W SAHARA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0375
Practice Address - Country:US
Practice Address - Phone:702-871-4990
Practice Address - Fax:702-871-9853
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice