Provider Demographics
NPI:1891015913
Name:ROBINSON, CHRIS S (DDS)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:S
Last Name:ROBINSON
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 1:2210 FORSYTHE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3613
Mailing Address - Country:US
Mailing Address - Phone:318-251-9655
Mailing Address - Fax:318-255-6113
Practice Address - Street 1:2210 FORSYTHE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3613
Practice Address - Country:US
Practice Address - Phone:318-251-9655
Practice Address - Fax:318-255-6113
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics