Provider Demographics
NPI:1063413847
Name:TAFT, ROBERT MICHAEL
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:TAFT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9326 W PARKHILL DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3967
Mailing Address - Country:US
Mailing Address - Phone:301-319-4509
Mailing Address - Fax:301-295-1783
Practice Address - Street 1:8901 WISCONSIN AVENUE
Practice Address - Street 2:BLDG 1, RM 16125
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-319-4509
Practice Address - Fax:301-295-1783
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA512101223P0700X
GA0097841223P0700X
NY041483-11223P0700X
ME31891223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0700XDental ProvidersDentistProsthodontics