Provider Demographics
NPI:1659339729
Name:ROBINSON, ROBERT H (DMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:ROBINSON
Suffix:
Gender:M
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:PO BOX 897
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-0897
Mailing Address - Country:US
Mailing Address - Phone:770-339-4260
Mailing Address - Fax:770-963-6322
Practice Address - Street 1:455 GRAYSON HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-7171
Practice Address - Country:US
Practice Address - Phone:770-339-5642
Practice Address - Fax:770-963-6138
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0093751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000223858EMedicaid
GA000223858HMedicaid
GA000223858IMedicaid
GA000223858KMedicaid
GA000223858JMedicaid