Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DS024246L | PA |
NPI | 1467487199 |
---|---|
Provider Name | Dr. Robert Willard Failing |
First Address | Forestdale, MA 02644-1228 |
Second Address | Buzzards Bay, MA 02542-1313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |