Provider Demographics
NPI:1417007600
Name:HAWKINS, ROBERT E (DMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4201 S CLOVERLEAF DR
Mailing Address - Street 2:Q
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6438
Mailing Address - Country:US
Mailing Address - Phone:636-928-0209
Mailing Address - Fax:636-928-0274
Practice Address - Street 1:4201 S CLOVERLEAF DR
Practice Address - Street 2:B
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6438
Practice Address - Country:US
Practice Address - Phone:636-928-0209
Practice Address - Fax:636-928-0274
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO132011223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology