Provider Demographics
NPI:1538290598
Name:ROBINSON, HAROLD EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:EDWARD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3934 AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-4916
Mailing Address - Country:US
Mailing Address - Phone:719-545-4242
Mailing Address - Fax:
Practice Address - Street 1:2020 WADSWORTH BLVD STE 18A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5730
Practice Address - Country:US
Practice Address - Phone:303-431-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02029742Medicaid