Individual
ROBERT H MOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
940 RICHARD ROAD, DYER, IN 46311-1936
(219) 865-0940
(219) 865-0941
Mailing address
940 RICHARD ROAD, DYER, IN 46311-1936
(219) 865-0940
(219) 865-0941
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
IL
1223G0001X
General Practice Dentistry
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003022
—
IL
Enumeration date
12/05/2006
Last updated
07/08/2007
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