Provider Demographics
NPI:1528102894
Name:CHRIST, ROBERT MATTHEW (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MATTHEW
Last Name:CHRIST
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 RIDGELINE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-9102
Mailing Address - Country:US
Mailing Address - Phone:727-934-1200
Mailing Address - Fax:727-934-4499
Practice Address - Street 1:3033 RIDGELINE BLVD STE A
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688-9102
Practice Address - Country:US
Practice Address - Phone:727-934-1200
Practice Address - Fax:727-934-4499
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN81311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice