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General NPI Number Information
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NPI Number | 1285171017
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Entity Type | Organization
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Legal Business Name | JEFFREY C ROBERTSON DDSINC
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 4940 IRVINE BLVD SUITE 101
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City | IRVINE
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State | CA
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Zip | 92620-1959
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Country | US
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Telephone | 714-838-7272
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Fax | 714-838-0030
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Provider Business Mailing Address
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Address Line | 4940 IRVINE BLVD SUITE 101
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City | IRVINE
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State | CA
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Zip | 92620-1959
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Country | US
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Telephone | 714-838-7272
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Fax | 714-838-0030
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY C ROBERTSON
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Credential | DDS
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Telephone | 714-838-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 33981
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License Number State | CA
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