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General NPI Number Information
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NPI Number | 1578573945
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Entity Type | Individual
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Provider Name | ROBERT SCOTT KNIERIM DDS
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 259 HYDRAULIC RIDGE ROAD SUITE 203
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-8974
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Country | US
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Telephone | 434-973-1222
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Fax | 434-973-2255
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Provider Business Mailing Address
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Address Line | 259 HYDRAULIC RIDGE RD SUITE 203
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-8128
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Country | US
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Telephone | 434-973-1222
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Fax | 434-973-2255
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401005008
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License Number State | VA
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