Provider Demographics
NPI:1841204302
Name:ROBINSON, MARJORIE BLOCK (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:BLOCK
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARJORIE
Other - Middle Name:SUZANNE
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:15 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075
Mailing Address - Country:US
Mailing Address - Phone:413-536-4455
Mailing Address - Fax:413-532-1757
Practice Address - Street 1:15 DAYTON ST
Practice Address - Street 2:
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075
Practice Address - Country:US
Practice Address - Phone:413-536-4455
Practice Address - Fax:413-532-1757
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice