Individual
DR. ROBERT LOUIS KETCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D
Contact information
Practice address
1120 E DUPONT RD, FORT WAYNE, IN 46825-1556
(260) 497-0497
(260) 489-4853
Mailing address
1120 E DUPONT RD, FORT WAYNE, IN 46825-1556
(260) 497-0497
(260) 489-4853
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
12006504A
IN
Other
Enumeration date
03/26/2007
Last updated
05/27/2008
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