Provider Demographics
NPI:1417036914
Name:PAOLINO, ROBERT MARTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARTIN
Last Name:PAOLINO
Suffix:
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 1:871 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342
Mailing Address - Country:US
Mailing Address - Phone:610-459-4179
Mailing Address - Fax:610-459-9242
Practice Address - Street 1:871 BALTIMORE PIKE
Practice Address - Street 2:SUITE 15
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342
Practice Address - Country:US
Practice Address - Phone:610-459-4179
Practice Address - Fax:610-459-9242
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0235264122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T02125Medicare UPIN
PA163841Medicare PIN