Provider Demographics
NPI:1740285279
Name:CSILLAG, ROBERT G (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:CSILLAG
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 1:475 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2652
Mailing Address - Country:US
Mailing Address - Phone:617-332-6447
Mailing Address - Fax:612-332-8689
Practice Address - Street 1:475 PARKER ST
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2652
Practice Address - Country:US
Practice Address - Phone:617-332-6447
Practice Address - Fax:612-332-8689
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist