Provider Demographics
NPI:1780947127
Name:ROBINSON, ERICA MCINNIS (DMD)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MCINNIS
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:ERICA
Other - Middle Name:MCINNIS
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3720 HARDY ST
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1550
Mailing Address - Country:US
Mailing Address - Phone:601-620-0460
Mailing Address - Fax:
Practice Address - Street 1:3720 HARDY ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1550
Practice Address - Country:US
Practice Address - Phone:601-620-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3653-12122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist