Provider Demographics
NPI:1992758650
Name:BILLS, ROBERT CONNER (DDS MS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CONNER
Last Name:BILLS
Suffix:
Gender:M
Credentials:DDS MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:109 MILLSAPS DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1587
Mailing Address - Country:US
Mailing Address - Phone:601-268-1234
Mailing Address - Fax:601-268-8648
Practice Address - Street 1:109 MILLSAPS DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1587
Practice Address - Country:US
Practice Address - Phone:601-268-1234
Practice Address - Fax:601-268-8648
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00064711Medicaid