Provider Demographics
NPI:1356665095
Name:KING, ROBERT E (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:KING
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 1:150 LAUREL OAK DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9385
Mailing Address - Country:US
Mailing Address - Phone:412-965-4671
Mailing Address - Fax:
Practice Address - Street 1:150 LAUREL OAK DR
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9385
Practice Address - Country:US
Practice Address - Phone:412-965-4671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0359261223G0001X
FLDN188831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice