Robert Leon Cole, DDS
Individual provider Active NPI Dentist · Spring Arbor, MI
NPI 1376695973 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376695973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 10314 (MI)
- Practice address
- 330 E Main Street
Spring Arbor, MI 49283-0338 - Phone
- (517) 750-1790
- Fax
- (517) 750-3117
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151202000452 | MI | Order and Referring Only - Dentist |
3678873338 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10314 | MI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10314 | MI | Yes |
Addresses
Primary practice location
330 E Main Street
Spring Arbor, MI 49283-0338
Mailing address
PO Box 338
330 E Main Street
Spring Arbor, MI 49283-0338
Phone (517) 750-1790
Other providers in Spring Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.