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NPI Code Detail

MEDICARE: ROBINSON DENTAL GROUP

MEDICARE: ROBINSON DENTAL GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry3464LA

General Provider Information

NPI Number : 1154628519
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBINSON DENTAL GROUP
Provider Business Mailing Address
First Line : 2629 COUNTRY CLUB RD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-5911
Country : US
Telephone Number : 337-474-3636
Fax Number : 337-474-0110
Provider Business Practice Location Address
First Line : 2629 COUNTRY CLUB RD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-5911
Country : US
Telephone Number : 337-474-3636
Fax Number : 337-474-0110
Authorized Official
Title or Position : OWNER/DOCTOR
Name : DR. TIMOTHY L ROBINSON
Credential : DDS
Telephone Number : 337-474-3636
Provider Enumeration Date : 02/22/2011
Last Update Date : 02/22/2011

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Directions to “ROBINSON DENTAL GROUP ” Practice Location

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