MEDICARE: ROBERT CAMERON WITT 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
1	1223G0001X	General Practice Dentistry	17306	NJ

General Provider Information

NPI Number	:	1326041815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT CAMERON WITT D.D.S.

Provider Business Mailing Address
First Line	:	206 MEADOW MOUNTAIN DRIVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712
Country	:	US
Telephone Number	:	908-507-4487
Fax Number	:	908-766-5604

Provider Business Practice Location Address
First Line	:	206 MEADOW MOUNTAIN DRIVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712
Country	:	US
Telephone Number	:	908-507-4487
Fax Number	:	908-766-5604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	12/08/2020

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