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General NPI Number Information
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NPI Number | 1255510590
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Entity Type | Organization
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Legal Business Name | ROBINWOOD SMILES LLC
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 11110 MEDICAL CAMPUS RD SUITE 148
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6700
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Country | US
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Telephone | 240-313-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 11110 MEDICAL CAMPUS RD SUITE 148
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFFICE
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Name | BEVERLY LONG BURKS
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Credential |
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Telephone | 240-313-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 13369
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License Number State | MD
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