Healthcare Provider Details

I. General information

NPI: 1609060896
Provider Name (Legal Business Name): ROBERT J. CHAPMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 ATLANTIC AVE. LEWIS WHARF
BOSTON MA
02110
US

IV. Provider business mailing address

28 ATLANTIC AVE. LEWIS WHARF
BOSTON MA
02110
US

V. Phone/Fax

Practice location:
  • Phone: 617-227-4831
  • Fax: 617-227-3174
Mailing address:
  • Phone: 617-227-4831
  • Fax: 617-227-3174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number10560
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: