Provider Demographics
NPI:1962688721
Name:FIEDLER, ROBIN LYDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LYDA
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 LYNDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-2046
Mailing Address - Country:US
Mailing Address - Phone:805-437-6130
Mailing Address - Fax:
Practice Address - Street 1:115 OLSEN BLVD NE
Practice Address - Street 2:
Practice Address - City:COKATO
Practice Address - State:MN
Practice Address - Zip Code:55321-4796
Practice Address - Country:US
Practice Address - Phone:320-286-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND121191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice