Provider Demographics
NPI:1467894972
Name:KNAPP, ROBERT DUAINE (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DUAINE
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65583-0455
Mailing Address - Country:US
Mailing Address - Phone:904-735-3636
Mailing Address - Fax:
Practice Address - Street 1:255 EASTLAWN
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584
Practice Address - Country:US
Practice Address - Phone:573-433-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013021622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist