Provider Demographics
NPI:1427032853
Name:RILLMAN, ERNEST ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:ANTHONY
Last Name:RILLMAN
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 1:10710 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3316
Mailing Address - Country:US
Mailing Address - Phone:727-399-2969
Mailing Address - Fax:727-399-2865
Practice Address - Street 1:10710 SEMINOLE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-3316
Practice Address - Country:US
Practice Address - Phone:727-399-2969
Practice Address - Fax:727-399-2865
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN116801223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics