Provider Demographics
NPI:1114027349
Name:T. MICHAEL ROBINSON, DDS,PC
Entity Type:Organization
Organization Name:T. MICHAEL ROBINSON, DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:T.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-643-5356
Mailing Address - Street 1:3221 NICHOL AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3148
Mailing Address - Country:US
Mailing Address - Phone:765-643-5356
Mailing Address - Fax:
Practice Address - Street 1:3221 NICHOL AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3148
Practice Address - Country:US
Practice Address - Phone:765-643-5356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty