Provider Demographics
NPI:1609060896
Name:CHAPMAN, ROBERT J (DMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:CHAPMAN
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 1:28 ATLANTIC AVE. LEWIS WHARF
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110
Mailing Address - Country:US
Mailing Address - Phone:617-227-4831
Mailing Address - Fax:617-227-3174
Practice Address - Street 1:28 ATLANTIC AVE. LEWIS WHARF
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110
Practice Address - Country:US
Practice Address - Phone:617-227-4831
Practice Address - Fax:617-227-3174
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105601223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics