Provider Demographics
NPI:1497794358
Name:PICKRON, ROBERT N (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:PICKRON
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 1:3294 MEDLOCK BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3082
Mailing Address - Country:US
Mailing Address - Phone:770-448-8882
Mailing Address - Fax:770-446-5511
Practice Address - Street 1:3294 MEDLOCK BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-3082
Practice Address - Country:US
Practice Address - Phone:770-448-8882
Practice Address - Fax:770-446-5511
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN006897122300000X
FLDN3824122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist