Provider Demographics
NPI:1235510199
Name:GEIMAN, ROBERT (DDS, MA, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:GEIMAN
Suffix:
Gender:M
Credentials:DDS, MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2230
Mailing Address - Country:US
Mailing Address - Phone:860-669-1616
Mailing Address - Fax:
Practice Address - Street 1:248 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-2230
Practice Address - Country:US
Practice Address - Phone:860-669-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0113921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics