Basic Information
| Provider Information | |||||||||
| NPI: | 1831296441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KINNEY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5211 CURRY FORD RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328128767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072751882 | ||||||||
| FaxNumber: | 4072752077 | ||||||||
| Practice Location | |||||||||
| Address1: | 2015 US HIGHWAY 441 N | ||||||||
| Address2: | |||||||||
| City: | OKEECHOBEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349721901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8637631951 | ||||||||
| FaxNumber: | 8445404798 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2006 | ||||||||
| LastUpdateDate: | 11/21/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DN134832 | FL | Y | Dental Providers | Dentist | General Practice |
No ID Information.