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General NPI Number Information
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NPI Number | 1629330683
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Entity Type | Organization
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Legal Business Name | RANDOLPH C ROBINSON MD
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 08/27/2014
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Provider Practice Location Address
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Address Line | 10375 PARK MEADOWS DR SUITE 150
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City | LONE TREE
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State | CO
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Zip | 80124-6735
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Country | US
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Telephone | 303-792-2828
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Fax | 303-792-3328
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Provider Business Mailing Address
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Address Line | 10375 PARK MEADOWS DR SUITE 150
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City | LONE TREE
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State | CO
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Zip | 80124-6735
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Country | US
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Telephone | 303-792-2828
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Fax | 303-792-3328
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. RANDOLPH C ROBINSON
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Credential | M.D., DDS
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Telephone | 303-792-2828
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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 | 6757
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 6757
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 31972
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 31972
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License Number State | CO
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