Provider Demographics
NPI:1538163498
Name:MITTON, ROBERT HUGH (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HUGH
Last Name:MITTON
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 1:9020 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1543
Mailing Address - Country:US
Mailing Address - Phone:240-603-4611
Mailing Address - Fax:
Practice Address - Street 1:5111 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3251
Practice Address - Country:US
Practice Address - Phone:703-681-0039
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159331223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health