Provider Demographics
NPI:1750433520
Name:JAMES L ROBBINS DMD, ORAL & MAXILLOFACIAL SURGERY, LLC
Entity type:Organization
Organization Name:JAMES L ROBBINS DMD, ORAL & MAXILLOFACIAL SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-565-7200
Mailing Address - Street 1:200 E STATE ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3434
Mailing Address - Country:US
Mailing Address - Phone:610-565-7200
Mailing Address - Fax:610-565-3770
Practice Address - Street 1:200 E STATE ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3434
Practice Address - Country:US
Practice Address - Phone:610-565-7200
Practice Address - Fax:610-565-3770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022786L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty