Cross, Robert Edward
Cross, Robert Edward is an individual health care provider with primary practice located at 134 Mckinley St , East Peoria IL 61611-2550. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Cross, Robert Edward can be contacted via phone (309) 699-6770.Contact Information
Primary practice address
134 Mckinley St
East Peoria IL 61611-2550
Phone: (309) 699-6770
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / General Practice | 1223G0001X | 19A11147 | Illinois |
Profile Details
NPI number | 1841344173 |
---|---|
LBN Legal business name | Cross, Robert Edward |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 23rd, 2007 |
Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841344173 | NPPES |
Illinois | MEDICAID | 19A11147 |
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