MEDICARE: HUGH MARCHMONT-ROBINSON DDS SC

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)		IL

General Provider Information

NPI Number	:	1578543245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUGH MARCHMONT-ROBINSON DDS SC

Provider Business Mailing Address
First Line	:	3302 SOUTH GROVE
Second Line	:
City	:	BERWYN
State	:	IL
Zip	:	60402
Country	:	US
Telephone Number	:	708-788-8200
Fax Number	:	708-795-8997

Provider Business Practice Location Address
First Line	:	3302 SOUTH GROVE
Second Line	:
City	:	BERWYN
State	:	IL
Zip	:	60402
Country	:	US
Telephone Number	:	708-788-8200
Fax Number	:	708-795-8997

Authorized Official
Title or Position	:	OWNER
Name	:	HUGH MARCHMONT-ROBINSON
Credential	:	DDS
Telephone Number	:	708-788-8200

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	08/22/2020

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