Provider Demographics
NPI:1881859387
Name:ROBISON, LAURA PATRICIA (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:PATRICIA
Last Name:ROBISON
Suffix:
Gender:F
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17878 E REPOSA CT
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85218-7513
Mailing Address - Country:US
Mailing Address - Phone:505-330-8444
Mailing Address - Fax:
Practice Address - Street 1:5747 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2401
Practice Address - Country:US
Practice Address - Phone:520-745-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ75261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics