Provider Demographics
NPI:1437410149
Name:TAMARA K ROBISON DDS PA
Entity Type:Organization
Organization Name:TAMARA K ROBISON DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MBA, PA
Authorized Official - Phone:239-263-4517
Mailing Address - Street 1:15495 TAMIAMI TRL N
Mailing Address - Street 2:#125
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-6206
Mailing Address - Country:US
Mailing Address - Phone:239-263-4517
Mailing Address - Fax:239-263-4518
Practice Address - Street 1:15495 TAMIAMI TRL N
Practice Address - Street 2:#125
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-6206
Practice Address - Country:US
Practice Address - Phone:239-263-4517
Practice Address - Fax:239-263-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN189591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty