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General NPI Number Information
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NPI Number | 1609293471
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Entity Type | Organization
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Legal Business Name | ROBERT S. FLORES DMD, INC
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 878 BOYSEN AVENUE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405
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Country | US
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Telephone | 805-544-9440
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Fax | 805-544-9458
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Provider Business Mailing Address
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Address Line | 878 BOYSEN AVENUE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405
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Country | US
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Telephone | 805-544-9440
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Fax | 805-544-9458
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT STEPHEN FLORES
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Credential | D.M.D.
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Telephone | 805-544-9440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | CA57573
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License Number State | CA
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