MEDICARE: KIRBY JOE ROBINSON OF TEXAS, DDS, P.C.

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
1	122300000X	Dentist	0016454	TX

General Provider Information

NPI Number	:	1316129489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRBY JOE ROBINSON OF TEXAS, DDS, P.C.

Provider Business Mailing Address
First Line	:	2317 W UNIVERSITY DR STE B8
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-1699
Country	:	US
Telephone Number	:	940-566-0127
Fax Number	:

Provider Business Practice Location Address
First Line	:	2317 W UNIVERSITY DR STE B8
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-1699
Country	:	US
Telephone Number	:	940-566-0127
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	THOMAS JOHN KENNEDY
Credential	:	DDS
Telephone Number	:	800-658-2177

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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