Provider Demographics
NPI:1619778610
Name:CASE, ROBERT CLIFTON IV (DMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CLIFTON
Last Name:CASE
Suffix:IV
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 1:139 CALUMET CT
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2279
Mailing Address - Country:US
Mailing Address - Phone:859-957-3535
Mailing Address - Fax:
Practice Address - Street 1:528 W BALDWIN RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3313
Practice Address - Country:US
Practice Address - Phone:850-215-0128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program