Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 009784 | GA |
N | 1223P0700X | Prosthodontist | 041483-1 | NY |
N | 1223P0700X | Prosthodontist | 3189 | ME |
N | 1223P0700X | Prosthodontist | 51210 | CA |
NPI | 1063413847 |
---|---|
Provider Name | Dr. Robert Michael Taft |
First Address | Bethesda, MD 20814-3967 |
Second Address | Bethesda, MD 20889-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 08/07/2007 |