Provider Demographics
NPI:1922235399
Name:ROBINSON, VICTOR A (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:A
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 1:8265 HIGHWAY 92 STE 116
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-6520
Mailing Address - Country:US
Mailing Address - Phone:678-905-0203
Mailing Address - Fax:
Practice Address - Street 1:8265 HIGHWAY 92 STE 116
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6520
Practice Address - Country:US
Practice Address - Phone:678-905-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN002026651223G0001X
NY390200000X
GADN0152491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program