Provider Demographics
NPI:1710917208
Name:ROBISON, BART FREDERICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:BART
Middle Name:FREDERICK
Last Name:ROBISON
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 1:3710 168TH ST NE
Mailing Address - Street 2:BLDG D SUITE 101
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223
Mailing Address - Country:US
Mailing Address - Phone:360-651-9394
Mailing Address - Fax:360-651-9262
Practice Address - Street 1:3710 168TH ST NE
Practice Address - Street 2:BLDG D SUITE 101
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-651-9394
Practice Address - Fax:360-651-9262
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00008488122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA131863OtherWA STATE L & I
8927241OtherCRIME VICT PROVIDER #