Provider Demographics
NPI:1447521810
Name:ROBINSON, KEITH A (DMD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:ROBINSON
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 1:40 WELDON PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-3202
Mailing Address - Country:US
Mailing Address - Phone:314-254-4000
Mailing Address - Fax:
Practice Address - Street 1:40 WELDON PKWY
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-3202
Practice Address - Country:US
Practice Address - Phone:314-882-8249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028696122300000X
MO2013016294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist