Provider Demographics
NPI:1437144458
Name:CRITTENDEN, ROBERT M (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:CRITTENDEN
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 1:3109 FREDERICK AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2911
Mailing Address - Country:US
Mailing Address - Phone:816-232-2300
Mailing Address - Fax:816-364-4373
Practice Address - Street 1:3109 FREDERICK AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2911
Practice Address - Country:US
Practice Address - Phone:816-232-2300
Practice Address - Fax:816-364-4373
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH218351223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery