Provider Demographics
NPI:1750494779
Name:STEELY, ROBIN P (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:P
Last Name:STEELY
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5761 MORGAN RD E
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-2659
Mailing Address - Country:US
Mailing Address - Phone:269-968-8151
Mailing Address - Fax:269-968-9659
Practice Address - Street 1:5761 MORGAN RD E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-2659
Practice Address - Country:US
Practice Address - Phone:269-968-8151
Practice Address - Fax:269-968-9659
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI132311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4062899Medicaid