Provider Demographics
NPI:1790801603
Name:KEEVER, ROBERT ALBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALBERT
Last Name:KEEVER
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 1:509 OLIVE WY
Mailing Address - Street 2:#1132
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-447-9397
Mailing Address - Fax:206-315-2213
Practice Address - Street 1:509 OLIVE WY
Practice Address - Street 2:#1132
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-447-9397
Practice Address - Fax:206-315-2213
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00005447122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist