Provider Demographics
NPI:1730476268
Name:QUINTON C. ROBINSON III, D.D.S., M.S., PLLC
Entity Type:Organization
Organization Name:QUINTON C. ROBINSON III, D.D.S., M.S., PLLC
Other - Org Name:QUINTON C. ROBINSON III, D.D.S., M.S., PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:QUINTON
Authorized Official - Middle Name:CARTY
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-683-6770
Mailing Address - Street 1:5180 PARK AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3521
Mailing Address - Country:US
Mailing Address - Phone:901-683-6770
Mailing Address - Fax:901-766-1640
Practice Address - Street 1:5180 PARK AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3521
Practice Address - Country:US
Practice Address - Phone:901-683-6770
Practice Address - Fax:901-766-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS43291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3225510Medicaid