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General NPI Number Information
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NPI Number | 1053547166
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Entity Type | Individual
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Provider Name | ROBERT TODD TIPTON DMD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 3112 N MAIN ST
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City | ANDERSON
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State | SC
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Zip | 29621-2763
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Country | US
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Telephone | 864-716-2118
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Fax | 864-225-3906
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Provider Business Mailing Address
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Address Line | 400 GALLERIA PKWY SE SUITE 800
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City | ATLANTA
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State | GA
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Zip | 30339-5980
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Country | US
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Telephone | 678-904-5665
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Fax | 678-247-7862
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4578
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8702
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License Number State | KY
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