Provider Demographics
NPI:1073696795
Name:SHAPIRO, ROBERT A (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:522 N NEW BALLAS ROAD
Mailing Address - Street 2:SUITE 152
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6820
Mailing Address - Country:US
Mailing Address - Phone:314-569-2050
Mailing Address - Fax:314-569-2014
Practice Address - Street 1:522 N NEW BALLAS ROAD
Practice Address - Street 2:SUITE 152
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6820
Practice Address - Country:US
Practice Address - Phone:314-569-2050
Practice Address - Fax:314-569-2014
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO19991402301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics