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General NPI Number Information
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NPI Number | 1083736821
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Entity Type | Individual
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Provider Name | ROBERT E WALINCHUS D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 132 SOUTHERN BLVD
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City | SAVANNAH
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State | GA
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Zip | 31405-7414
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Country | US
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Telephone | 912-226-0019
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Fax | 912-356-1837
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Provider Business Mailing Address
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Address Line | 132 SOUTHERN BLVD
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City | SAVANNAH
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State | GA
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Zip | 31405-7414
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Country | US
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Telephone | 912-226-0019
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Fax | 610-543-0299
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN016031
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License Number State | GA
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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 | DS024091L
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License Number State | PA
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