MEDICARE: DR. JOHN EDGAR ROBINSON DMD

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	012084	GA

General Provider Information

NPI Number	:	1669560066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN EDGAR ROBINSON DMD

Provider Business Mailing Address
First Line	:	2855 HENDERSON MILL RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-5772
Country	:	US
Telephone Number	:	770-939-7167
Fax Number	:	770-939-6519

Provider Business Practice Location Address
First Line	:	2855 HENDERSON MILL RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-5772
Country	:	US
Telephone Number	:	770-939-7167
Fax Number	:	770-939-6519

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	03/23/2017

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