Provider Demographics
NPI:1174666838
Name:MANTONI, ROBERT RAYMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RAYMOND
Last Name:MANTONI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 GEORGIA AVE STE 600E
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3955
Mailing Address - Country:US
Mailing Address - Phone:301-587-7406
Mailing Address - Fax:301-495-2694
Practice Address - Street 1:8730 GEORGIA AVE STE 600E
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3955
Practice Address - Country:US
Practice Address - Phone:301-587-7406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD67021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice