Provider Demographics
NPI:1609124767
Name:GILDNER, ROBERT KENNY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KENNY
Last Name:GILDNER
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 1:602 E MAIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3730
Mailing Address - Country:US
Mailing Address - Phone:803-957-2440
Mailing Address - Fax:
Practice Address - Street 1:602 E MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3730
Practice Address - Country:US
Practice Address - Phone:803-957-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice