Provider Demographics
NPI:1841415429
Name:ROBIN A MYERS DMD PC
Entity Type:Organization
Organization Name:ROBIN A MYERS DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-524-4050
Mailing Address - Street 1:45 FORESTWOOD DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6213
Mailing Address - Country:US
Mailing Address - Phone:570-524-4050
Mailing Address - Fax:570-524-4450
Practice Address - Street 1:45 FORESTWOOD DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6213
Practice Address - Country:US
Practice Address - Phone:570-524-4050
Practice Address - Fax:570-524-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029274L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty