Provider Demographics
NPI:1164920187
Name:ROBINSON DENTAL & IMPLANTS
Entity Type:Organization
Organization Name:ROBINSON DENTAL & IMPLANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-725-3368
Mailing Address - Street 1:675 RODEO DR
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:UT
Mailing Address - Zip Code:84066-3714
Mailing Address - Country:US
Mailing Address - Phone:435-725-3368
Mailing Address - Fax:435-725-3370
Practice Address - Street 1:675 RODEO DR
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:UT
Practice Address - Zip Code:84066-3714
Practice Address - Country:US
Practice Address - Phone:435-725-3368
Practice Address - Fax:435-725-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6890810-9923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty