Provider Demographics
NPI:1639188741
Name:HAWKINS, ROBERT B (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:HAWKINS
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 1:2855 W STATE ROAD 434
Mailing Address - Street 2:SUITE 1031
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4480
Mailing Address - Country:US
Mailing Address - Phone:407-862-2299
Mailing Address - Fax:
Practice Address - Street 1:2855 W STATE ROAD 434
Practice Address - Street 2:SUITE 1031
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4480
Practice Address - Country:US
Practice Address - Phone:407-862-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN FL 81811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice