MEDICARE: DR. KERRY ROBSON DDS

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	1223G0001X	General Practice Dentistry	009903	FL

General Provider Information

NPI Number	:	1649303843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRY ROBSON DDS

Provider Business Mailing Address
First Line	:	5035 CROSS POINTE DR
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-5213
Country	:	US
Telephone Number	:	727-784-1514
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 TAMPA RD
Second Line	:	SUITE 201
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3609
Country	:	US
Telephone Number	:	727-786-8302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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