Provider Demographics
NPI:1881709475
Name:WALDMAN, ROBERT H (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:WALDMAN
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 1:3042 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2731
Mailing Address - Country:US
Mailing Address - Phone:925-682-6940
Mailing Address - Fax:925-827-2427
Practice Address - Street 1:3042 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2731
Practice Address - Country:US
Practice Address - Phone:925-682-6940
Practice Address - Fax:925-827-2427
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO318781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice