Provider Demographics
NPI:1124120191
Name:MANSMAN, II, ROBERT WILLIAM II (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:MANSMAN, II
Suffix:II
Gender:M
Credentials:DDS
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Mailing Address - Street 1:7360 GUILFORD DRIVE, SUITE #102
Mailing Address - Street 2:PEDIATRIC DENTAL CENTER OF FREDERICK
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704
Mailing Address - Country:US
Mailing Address - Phone:301-668-2662
Mailing Address - Fax:301-668-6130
Practice Address - Street 1:7360 GUILFORD DRIVE, SUITE #102
Practice Address - Street 2:PEDIATRIC DENTAL CENTER OF FREDERICK
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704
Practice Address - Country:US
Practice Address - Phone:301-668-2662
Practice Address - Fax:301-668-6130
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2011-12-06
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Provider Licenses
StateLicense IDTaxonomies
VA0401411486122300000X
MD141651223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist