Provider Demographics
NPI:1306204037
Name:ROBINSON, MAURA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13001 N OUTER 40 RD STE 360
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5941
Mailing Address - Country:US
Mailing Address - Phone:314-626-4579
Mailing Address - Fax:314-485-4820
Practice Address - Street 1:13001 N OUTER 40 RD STE 360
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-5941
Practice Address - Country:US
Practice Address - Phone:314-626-4579
Practice Address - Fax:314-485-4820
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-09
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016023890122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist