Provider Demographics
NPI:1215155924
Name:KEATING, ROBERT E (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:KEATING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S VICTORIA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5314
Mailing Address - Country:US
Mailing Address - Phone:805-642-7645
Mailing Address - Fax:805-644-0728
Practice Address - Street 1:801 S VICTORIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5314
Practice Address - Country:US
Practice Address - Phone:805-642-7645
Practice Address - Fax:805-644-0728
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist