Healthcare Provider Details

I. General information

NPI: 1861481327
Provider Name (Legal Business Name): HEATHER EILEEN ROBINSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 02/10/2024
Certification Date: 02/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4227 ARBOR BAY
WOODBURY MN
55129-4420
US

IV. Provider business mailing address

4227 ARBOR BAY
WOODBURY MN
55129-4420
US

V. Phone/Fax

Practice location:
  • Phone: 651-788-8666
  • Fax: 651-788-8666
Mailing address:
  • Phone: 651-788-8666
  • Fax: 651-788-8666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberD11600
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberS146
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: