Provider Demographics
NPI:1164620688
Name:FOSTER, ROBERT H (DDS ,MAGD ,FICD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DDS ,MAGD ,FICD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3535
Mailing Address - Country:US
Mailing Address - Phone:407-656-4411
Mailing Address - Fax:407-654-2098
Practice Address - Street 1:522 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3535
Practice Address - Country:US
Practice Address - Phone:407-656-4411
Practice Address - Fax:407-654-2098
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice