Provider Demographics
NPI:1457403420
Name:WILLIMAN, ROBIN EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:EDWARD
Last Name:WILLIMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S HAMMONDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2409
Mailing Address - Country:US
Mailing Address - Phone:410-859-0335
Mailing Address - Fax:
Practice Address - Street 1:310 S HAMMONDS FERRY RD
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2409
Practice Address - Country:US
Practice Address - Phone:410-859-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD64921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice