Provider Demographics
NPI:1558490573
Name:WEBSTER, ROBERT W (ROBERT WEBSTER,DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:ROBERT WEBSTER,DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 S 4TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2078
Mailing Address - Country:US
Mailing Address - Phone:859-236-1912
Mailing Address - Fax:859-236-4589
Practice Address - Street 1:359 S 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2078
Practice Address - Country:US
Practice Address - Phone:859-236-1912
Practice Address - Fax:859-236-4589
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics