Provider Demographics
NPI:1871750943
Name:MATHER, ROBERT S (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:MATHER
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 1:2181 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-9698
Mailing Address - Country:US
Mailing Address - Phone:941-966-1805
Mailing Address - Fax:941-966-4999
Practice Address - Street 1:2181 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9698
Practice Address - Country:US
Practice Address - Phone:941-966-1805
Practice Address - Fax:941-966-4999
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL84381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice