Provider Demographics
NPI:1770551558
Name:CROSWELL, ROBIN JOY (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:JOY
Last Name:CROSWELL
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Gender:F
Credentials:DDS, MS
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Mailing Address - Street 1:2880 WAKEFIELD PINES DR
Mailing Address - Street 2:STE 110
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8998
Mailing Address - Country:US
Mailing Address - Phone:919-570-0180
Mailing Address - Fax:919-570-0280
Practice Address - Street 1:2880 WAKEFIELD PINES DR
Practice Address - Street 2:STE 110
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8998
Practice Address - Country:US
Practice Address - Phone:919-570-0180
Practice Address - Fax:919-570-0280
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC63291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9005POtherBLUE CROSS BLUE SHIELD
NC799005PMedicaid