Provider Demographics
NPI:1851454144
Name:LARSON, ROBIN S (DMD, PA)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:S
Last Name:LARSON
Suffix:
Gender:F
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 NW 76TH DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6635
Mailing Address - Country:US
Mailing Address - Phone:352-331-4080
Mailing Address - Fax:352-332-6694
Practice Address - Street 1:220 NW 76TH DR
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6635
Practice Address - Country:US
Practice Address - Phone:352-331-4080
Practice Address - Fax:352-332-6694
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN120791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice