=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447430145
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT PAUL ROBBINS D.P.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2007
-----------------------------------------------------
Last Update Date | 11/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1346 8TH ST NE #200
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98002-4588
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-939-3540
-----------------------------------------------------
Fax | 253-939-7664
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1346 8TH ST NE #200
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98002-4588
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-939-3540
-----------------------------------------------------
Fax | 253-939-7664
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122400000X
-----------------------------------------------------
Taxonomy Name | Denturist
-----------------------------------------------------
License Number | DN00000310
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------