Wynn, Robert M.
Wynn, Robert M. is an sole proprietor health care provider with primary practice located at 4517 N Rockwood Dr , Peoria IL 61615-3841. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wynn, Robert M. can be contacted via phone (309) 688-1021.Contact Information
Primary practice address
4517 N Rockwood Dr
Peoria IL 61615-3841
Phone: (309) 688-1021
Fax: (309) 688-5643
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 019-021592 | Illinois |
| Dental Providers / General Practice | 1223G0001X | 019021592 | Illinois |
Profile Details
| NPI number | 1144352170 |
|---|---|
| LBN Legal business name | Wynn, Robert M. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Dec 10th, 2020 - about 4 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.
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