Provider Demographics
NPI:1407943236
Name:ELLIOTT, ROBERT D (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:DMD, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1700 KILDAIRE FARM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6572
Mailing Address - Country:US
Mailing Address - Phone:919-852-1322
Mailing Address - Fax:919-852-1230
Practice Address - Street 1:1700 KILDAIRE FARM RD STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6572
Practice Address - Country:US
Practice Address - Phone:919-852-1322
Practice Address - Fax:919-852-1230
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC67621223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1780894386OtherPEDIATRIC DENTISTRY