Basic Information
| Provider Information | |||||||||
| NPI: | 1366432171 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROCK | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | DEAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | LINCOLN STREET, BLDG #9900, 2ND FLOOR | ||||||||
| Address2: | USA DENTAC JOINT BASE LEWIS-MCCHORD | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539684032 | ||||||||
| FaxNumber: | 3157729692 | ||||||||
| Practice Location | |||||||||
| Address1: | 527 BARNES BLVD | ||||||||
| Address2: | MCCHORD AIR FORSE BASE DENTAL CLINIC | ||||||||
| City: | MCCHORD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539825505 | ||||||||
| FaxNumber: | 3157729692 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2005 | ||||||||
| LastUpdateDate: | 05/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 16872 | TX | Y | Dental Providers | Dentist | General Practice |
No ID Information.