Healthcare Provider Details

I. General information

NPI: 1467894972
Provider Name (Legal Business Name): ROBERT DUAINE KNAPP D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E OHIO ST
CLINTON MO
64735-3066
US

IV. Provider business mailing address

1200 E OHIO ST
CLINTON MO
64735-3066
US

V. Phone/Fax

Practice location:
  • Phone: 660-885-3632
  • Fax:
Mailing address:
  • Phone: 660-885-3632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2013021622
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2013021622
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: