Provider Demographics
NPI:1306212428
Name:REISZ, ROBIN LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:REISZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:755 E NEES AVE UNIT 27046
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8662
Mailing Address - Country:US
Mailing Address - Phone:559-435-7555
Mailing Address - Fax:559-435-7444
Practice Address - Street 1:1360 E SPRUCE AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3378
Practice Address - Country:US
Practice Address - Phone:559-860-2500
Practice Address - Fax:559-860-2502
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA469441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery