Individual
DR. ROBERT ELLIOTT ISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MPH
Contact information
Practice address
11155 INTERNATIONAL DR, RANCHO CORDOVA, CA 95670-6096
(916) 464-3794
(916) 464-3783
Mailing address
212 HUERTA PL, DAVIS, CA 95616-0271
(530) 758-1456
(775) 254-4491
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
21143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B21143
—
CA
05
—
B2114301
—
CA
Enumeration date
10/02/2006
Last updated
07/09/2007
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