Provider Demographics
NPI:1619988862
Name:WHITMORE, ROBERT ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALLEN
Last Name:WHITMORE
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 1:5975 S COOPER ST
Mailing Address - Street 2:SUITE #125
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4478
Mailing Address - Country:US
Mailing Address - Phone:817-557-1251
Mailing Address - Fax:817-557-1251
Practice Address - Street 1:5975 S COOPER ST
Practice Address - Street 2:SUITE #125
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4478
Practice Address - Country:US
Practice Address - Phone:817-468-1212
Practice Address - Fax:817-557-1212
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14269TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice