Provider Demographics
NPI:1750959615
Name:ROUSSEAU, ROBYN B (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:B
Last Name:ROUSSEAU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-1641
Mailing Address - Country:US
Mailing Address - Phone:207-442-7581
Mailing Address - Fax:207-442-7531
Practice Address - Street 1:304 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-1641
Practice Address - Country:US
Practice Address - Phone:207-442-7581
Practice Address - Fax:207-442-7531
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH46481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice