MEDICARE: DR. ROBERT HUGH MITTON 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	1223D0001X	Public Health Dentistry	15933	TX

General Provider Information

NPI Number	:	1538163498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HUGH MITTON D.D.S.

Provider Business Mailing Address
First Line	:	9020 EDGEWOOD DR
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-1543
Country	:	US
Telephone Number	:	240-603-4611
Fax Number	:

Provider Business Practice Location Address
First Line	:	5111 LEESBURG PIKE
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-3251
Country	:	US
Telephone Number	:	703-681-0039
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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