Healthcare Provider Details

I. General information

NPI: 1285752550
Provider Name (Legal Business Name): STEVEN DOUGLAS ROBINSON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 GRANT DR SUITE 10
RENO NV
89509-5301
US

IV. Provider business mailing address

3575 GRANT DR SUITE 10
RENO NV
89509-5301
US

V. Phone/Fax

Practice location:
  • Phone: 775-827-3302
  • Fax: 775-827-9095
Mailing address:
  • Phone: 775-827-3302
  • Fax: 775-827-9095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberS4-20
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: