MEDICARE: DR. ROBIN LYNN-PREGITZER SIMONTON 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	122300000X	Dentist	2901020041	MI

General Provider Information

NPI Number	:	1881910644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN LYNN-PREGITZER SIMONTON DDS

Provider Business Mailing Address
First Line	:	9271 SILVERSIDE
Second Line	:
City	:	SOUTH LYON
State	:	MI
Zip	:	48178-9316
Country	:	US
Telephone Number	:	810-923-8696
Fax Number	:

Provider Business Practice Location Address
First Line	:	9271 SILVERSIDE
Second Line	:
City	:	SOUTH LYON
State	:	MI
Zip	:	48178-9316
Country	:	US
Telephone Number	:	810-923-8696
Fax Number	:

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

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	04/19/2010

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