Provider Demographics
NPI:1730220476
Name:CROFT, ROBERT R (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:CROFT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:974 HARSH LN
Mailing Address - Street 2:
Mailing Address - City:CASTALIAN SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37031-4545
Mailing Address - Country:US
Mailing Address - Phone:209-404-2771
Mailing Address - Fax:
Practice Address - Street 1:98 MAYFIELD DR STE D
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3035
Practice Address - Country:US
Practice Address - Phone:615-355-5822
Practice Address - Fax:615-355-5899
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB200931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics