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General NPI Number Information
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NPI Number | 1720222383
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Entity Type | Individual
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Provider Name | ROBERT GERALD KEIM D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | USC SCHOOL OF DENTISTRY DEPARTMENT OF 925 WEST 34TH STREET, SUITE 312
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City | LOS ANGELES
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State | CA
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Zip | 90089-0001
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Country | US
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Telephone | 213-740-0410
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 MACGREGOR DOWNS RD MAIL STOP 701
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City | GREENVILLE
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State | NC
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Zip | 27834-5925
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Country | US
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Telephone | 252-737-7023
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | SP 189
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1412
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0183
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License Number State | NC
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