Provider Demographics
NPI:1053579458
Name:ROBERT W. EISBERG II, DDS, PA
Entity type:Organization
Organization Name:ROBERT W. EISBERG II, DDS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:EISBERG
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-878-1810
Mailing Address - Street 1:2630 TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2571
Mailing Address - Country:US
Mailing Address - Phone:919-878-1810
Mailing Address - Fax:919-878-1840
Practice Address - Street 1:2630 TIMBER DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2571
Practice Address - Country:US
Practice Address - Phone:919-878-1810
Practice Address - Fax:919-878-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty