Healthcare Provider Details

I. General information

NPI: 1154448116
Provider Name (Legal Business Name): ROBERT T. ROBINSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 SPRINGFIELD AVE
NEW PROVIDENCE NJ
07974-1501
US

IV. Provider business mailing address

1351 SPRINGFIELD AVE
NEW PROVIDENCE NJ
07974-1501
US

V. Phone/Fax

Practice location:
  • Phone: 908-464-5080
  • Fax: 908-464-6989
Mailing address:
  • Phone: 908-464-5080
  • Fax: 908-464-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number16444
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: