Provider Demographics
NPI:1114935376
Name:SPILLER, ROBERT ERNEST JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERNEST
Last Name:SPILLER
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GREENTREE DENTAL BLDG
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129
Mailing Address - Country:US
Mailing Address - Phone:812-288-6681
Mailing Address - Fax:
Practice Address - Street 1:82 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1652
Practice Address - Country:US
Practice Address - Phone:812-288-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN94291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics