Healthcare Provider Details

I. General information

NPI: 1508066580
Provider Name (Legal Business Name): WESLEY LLOYD ROBINSON DMD, PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7215 LEBANON RD SUITE B
CHARLOTTE NC
28227-9026
US

IV. Provider business mailing address

7215 LEBANON RD STE B
MINT HILL NC
28227-9027
US

V. Phone/Fax

Practice location:
  • Phone: 704-573-3331
  • Fax: 704-573-3332
Mailing address:
  • Phone: 704-545-2018
  • Fax: 704-545-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7891
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: