Provider Demographics
NPI:1871559047
Name:SHAKESPEARE, ROBERT CRAIG (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CRAIG
Last Name:SHAKESPEARE
Suffix:
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:9900 LINCOLN ST
Mailing Address - Street 2:SECOND FLOOR,
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-966-7675
Mailing Address - Fax:253-967-6459
Practice Address - Street 1:DEPT OF THE ARMY, DENTAL ACTIVITY STOP B
Practice Address - Street 2:2817 REILLY RD, MCDS-NA-B
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-396-5610
Practice Address - Fax:910-396-7017
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA000087861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice