Provider Demographics
NPI:1720222383
Name:KEIM, ROBERT GERALD (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GERALD
Last Name:KEIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 MACGREGOR DOWNS RD
Mailing Address - Street 2:MAIL STOP 701
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5925
Mailing Address - Country:US
Mailing Address - Phone:252-737-7023
Mailing Address - Fax:
Practice Address - Street 1:USC SCHOOL OF DENTISTRY DEPARTMENT OF
Practice Address - Street 2:925 WEST 34TH STREET, SUITE 312
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0001
Practice Address - Country:US
Practice Address - Phone:213-740-0410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 1891223X0400X
NM14121223X0400X
NC01831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics