Healthcare Provider Details

I. General information

NPI: 1356542773
Provider Name (Legal Business Name): ROBIN M RAWLINSON D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2861 PAWTUCKET AVE
RIVERSIDE RI
02915-4939
US

IV. Provider business mailing address

49 PEVERIL RD
CRANSTON RI
02921-2421
US

V. Phone/Fax

Practice location:
  • Phone: 401-434-1334
  • Fax:
Mailing address:
  • Phone: 401-383-9212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberRI02477
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: