Healthcare Provider Details

I. General information

NPI: 1447893870
Provider Name (Legal Business Name): JAMES KOLBY ROBINSON, DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2434 NW PROFESSIONAL DR
CORVALLIS OR
97330-3991
US

IV. Provider business mailing address

2434 NW PROFESSIONAL DR
CORVALLIS OR
97330-3991
US

V. Phone/Fax

Practice location:
  • Phone: 541-758-3604
  • Fax:
Mailing address:
  • Phone: 541-758-3604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. J KOBLY ROBINSON DMD
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 541-779-8923