Provider Demographics
NPI:1447523774
Name:ROBERT L. LERNER D.D.S
Entity type:Organization
Organization Name:ROBERT L. LERNER D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-349-4343
Mailing Address - Street 1:9500 INDEPENDENCE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-4617
Mailing Address - Country:US
Mailing Address - Phone:907-349-4343
Mailing Address - Fax:
Practice Address - Street 1:9500 INDEPENDENCE DR STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4617
Practice Address - Country:US
Practice Address - Phone:907-349-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
851261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center