Provider Demographics
NPI:1720197411
Name:TRAMONTANO, ROBERT CAMILLO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CAMILLO
Last Name:TRAMONTANO
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 1:101 PROSPECT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5003
Mailing Address - Country:US
Mailing Address - Phone:732-367-0880
Mailing Address - Fax:723-367-0880
Practice Address - Street 1:101 PROSPECT ST STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5003
Practice Address - Country:US
Practice Address - Phone:732-367-0880
Practice Address - Fax:723-367-0880
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ-104951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice