Provider Demographics
NPI:1881604684
Name:SPAULDING, ROBERT MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:SPAULDING
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 1:2535 CEANOTHUS AVE
Mailing Address - Street 2:SUITE 128
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7722
Mailing Address - Country:US
Mailing Address - Phone:530-343-3250
Mailing Address - Fax:530-343-2962
Practice Address - Street 1:1279 E 1ST AVE STE B
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1542
Practice Address - Country:US
Practice Address - Phone:530-343-3250
Practice Address - Fax:530-343-2962
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice