Provider Demographics
NPI:1861494494
Name:MULLINS, ROB CASEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROB
Middle Name:CASEY
Last Name:MULLINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18525 E SMOKY HILL RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3108
Mailing Address - Country:US
Mailing Address - Phone:303-617-9090
Mailing Address - Fax:303-617-9838
Practice Address - Street 1:18525 E SMOKY HILL RD
Practice Address - Street 2:SUITE D
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3108
Practice Address - Country:US
Practice Address - Phone:303-617-9090
Practice Address - Fax:303-617-9838
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist