Robert Duane Douglas, D.M.D., M.S. Valid NPI

Individual provider · Prosthodontics · East Alton, IL

NPI

1003938663

Type

Individual (Type 1)

Primary specialty

Prosthodontics (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223P0700X

License number

021002025 (IL)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-04-04

Last updated

2022-12-14