Provider Demographics
NPI:1134323876
Name:JACY ROBLING D.D.S., P.C.
Entity Type:Organization
Organization Name:JACY ROBLING D.D.S., P.C.
Other - Org Name:ALL SMILES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROBLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-362-9245
Mailing Address - Street 1:PO BOX 1099
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-0693
Mailing Address - Country:US
Mailing Address - Phone:765-362-9245
Mailing Address - Fax:765-362-9250
Practice Address - Street 1:116 WALTER REMLEY DR
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-3350
Practice Address - Country:US
Practice Address - Phone:765-362-9245
Practice Address - Fax:765-362-9250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120104611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty