Provider Demographics
NPI:1164041232
Name:ROBBINS, THOMAS JERRY (DMD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JERRY
Last Name:ROBBINS
Suffix:
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 1:3573 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3043
Mailing Address - Country:US
Mailing Address - Phone:803-973-4530
Mailing Address - Fax:
Practice Address - Street 1:3573 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3043
Practice Address - Country:US
Practice Address - Phone:803-973-4530
Practice Address - Fax:803-973-4533
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101171223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain