Healthcare Provider Details

I. General information

NPI: 1457412751
Provider Name (Legal Business Name): R. MICHAEL ROBINSON, DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7508 HIGHWAY 43 SOUTH
MCINTOSH AL
36553
US

IV. Provider business mailing address

PO BOX 388 7508 HWY 43 SOUTH
MC INTOSH AL
36553-0388
US

V. Phone/Fax

Practice location:
  • Phone: 251-944-2283
  • Fax: 251-944-2296
Mailing address:
  • Phone: 251-944-2283
  • Fax: 251-944-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3888
License Number StateAL

VIII. Authorized Official

Name: DR. RODNEY MICHAEL ROBINSON
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 251-944-2283