Provider Demographics
NPI:1326486713
Name:WATERS, ROBERT DAVID (DDS,FAGD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:WATERS
Suffix:
Gender:M
Credentials:DDS,FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710 OXON HILL ROAD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745
Mailing Address - Country:US
Mailing Address - Phone:301-248-3810
Mailing Address - Fax:
Practice Address - Street 1:6710 OXON HILL RD
Practice Address - Street 2:SUITE 350
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1117
Practice Address - Country:US
Practice Address - Phone:301-248-3810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist