Provider Demographics
NPI:1730203910
Name:VIVENTI, ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:VIVENTI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 WASHINGTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:508-698-1685
Mailing Address - Fax:
Practice Address - Street 1:470 WASHINGTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-769-3566
Practice Address - Fax:781-769-0992
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice