| Doctor Name: | DR. ROBERT DUANE DOUGLAS |
| NPI Number: | 1003938663 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.M.D., M.S. |
| License Number: | |
| Business Practice Address: | 160 S Bellwood Dr Ste B East Alton, IL - 620242086 |
| Business Phone Number: | 6182581300 |
| Business Fax Number: | |
| Mailing Address: | 160 S Bellwood Dr Ste B, EAST ALTON |
| State: | IL |
| Postal Code: | 620242086 |
| Phone Number: | 6182581300 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Prosthodontics |
| Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |