Provider Demographics
NPI:1780025353
Name:CHAFFIN, ROBERT FAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FAY
Last Name:CHAFFIN
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:PO BOX 1359
Mailing Address - Street 2:
Mailing Address - City:CHINOOK
Mailing Address - State:MT
Mailing Address - Zip Code:59523-1359
Mailing Address - Country:US
Mailing Address - Phone:406-357-2668
Mailing Address - Fax:406-357-2663
Practice Address - Street 1:419 PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:CHINOOK
Practice Address - State:MT
Practice Address - Zip Code:59523-9726
Practice Address - Country:US
Practice Address - Phone:406-357-2668
Practice Address - Fax:406-357-2663
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-5986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist