Provider Demographics
NPI:1518963966
Name:CHILDS, ROBERT F (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:CHILDS
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 1:18449 BROOKHURST ST
Mailing Address - Street 2:STE 9
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6751
Mailing Address - Country:US
Mailing Address - Phone:714-378-2705
Mailing Address - Fax:714-378-9374
Practice Address - Street 1:18449 BROOKHURST ST
Practice Address - Street 2:STE 9
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6751
Practice Address - Country:US
Practice Address - Phone:714-378-2705
Practice Address - Fax:714-378-9374
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA256881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice