Healthcare Provider Details

I. General information

NPI: 1669511994
Provider Name (Legal Business Name): ROBERT J FLINTON A.B., M.S., D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 BERGEN STREET, SUITE 7700 CENTER FOR DENTAL AND ORAL HEALTH
NEWARK NJ
07101-2400
US

IV. Provider business mailing address

42 MOUNTAIN VIEW RD
WARREN NJ
07059-7700
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-2444
  • Fax: 972-972-2441
Mailing address:
  • Phone: 973-972-4186
  • Fax: 973-972-0370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number19262
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: