Provider Demographics
NPI:1336282045
Name:ELIASBERG, ROBIN SUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:SUE
Last Name:ELIASBERG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 STANFORD RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1227
Mailing Address - Country:US
Mailing Address - Phone:508-875-1234
Mailing Address - Fax:
Practice Address - Street 1:326 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6309
Practice Address - Country:US
Practice Address - Phone:508-875-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA172161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry