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NPI Code Detail

MEDICARE: DR. BRENT TYLER ROBISON DMD, MS, MSD

MEDICARE:  DR. BRENT TYLER ROBISON  DMD, MS, MSD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryD5402AZ

General Provider Information

NPI Number : 1205011095
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENT TYLER ROBISON DMD, MS, MSD
Provider Business Mailing Address
First Line : 1355 S HIGLEY RD STE 105
Second Line :
City : GILBERT
State : AZ
Zip : 85296-4799
Country : US
Telephone Number : 480-888-7711
Fax Number :
Provider Business Practice Location Address
First Line : 1355 S HIGLEY RD STE 105
Second Line :
City : GILBERT
State : AZ
Zip : 85296-4799
Country : US
Telephone Number : 480-888-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2007
Last Update Date : 12/31/2007

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Directions to “ DR. BRENT TYLER ROBISON DMD, MS, MSD” Practice Location

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