Provider Demographics
NPI:1336157742
Name:ROBINSON, LANCE ELLIOT (DMD)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:ELLIOT
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079
Mailing Address - Country:US
Mailing Address - Phone:610-586-6520
Mailing Address - Fax:610-534-9859
Practice Address - Street 1:938 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079
Practice Address - Country:US
Practice Address - Phone:610-586-6520
Practice Address - Fax:610-534-9859
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019940L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
193799OtherBLUE SHIELD