Provider Demographics
NPI:1740340561
Name:STEPHEN W. ROBINSON, DDS, PA
Entity type:Organization
Organization Name:STEPHEN W. ROBINSON, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MSD
Authorized Official - Phone:763-546-6700
Mailing Address - Street 1:3475 PLYMOUTH BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1499
Mailing Address - Country:US
Mailing Address - Phone:763-546-6700
Mailing Address - Fax:763-546-6702
Practice Address - Street 1:3475 PLYMOUTH BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1499
Practice Address - Country:US
Practice Address - Phone:763-546-6700
Practice Address - Fax:763-546-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND74631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty