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NPI Code Detail

MEDICARE: ROBERT C DILLMAN D.D.S.

MEDICARE: ROBERT C DILLMAN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry3509WI

General Provider Information

NPI Number : 1184798829
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT C DILLMAN D.D.S.
Provider Business Mailing Address
First Line : 851 PARK DR
Second Line : SUITE 101
City : LAKE GENEVA
State : WI
Zip : 53147-4586
Country : US
Telephone Number : 262-248-4991
Fax Number : 262-248-0397
Provider Business Practice Location Address
First Line : 851 PARK DR
Second Line : SUITE 101
City : LAKE GENEVA
State : WI
Zip : 53147-4586
Country : US
Telephone Number : 262-248-4991
Fax Number : 262-248-0397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/08/2007

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