Provider Demographics
NPI:1881620771
Name:NADEAU, ROBERT ALLAN (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALLAN
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:730 N 4TH ST UNIT 402
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1985
Mailing Address - Country:US
Mailing Address - Phone:816-769-1661
Mailing Address - Fax:
Practice Address - Street 1:515 DELAWARE ST. SE
Practice Address - Street 2:7-174D MALCOLM MOOS TOWER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-301-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060151871223S0112X
MNS881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery