MEDICARE: DR. VICTOR A ROBINSON 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	DEN00202665	CO
2	390200000X	Student in an Organized Health Care Education/Training Program		NY
3	1223G0001X	General Practice Dentistry	DN015249	GA

General Provider Information

NPI Number	:	1922235399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR A ROBINSON DDS

Provider Business Mailing Address
First Line	:	8265 HIGHWAY 92 STE 116
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6520
Country	:	US
Telephone Number	:	678-905-0203
Fax Number	:

Provider Business Practice Location Address
First Line	:	8265 HIGHWAY 92 STE 116
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6520
Country	:	US
Telephone Number	:	678-905-0203
Fax Number	:

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

Provider Enumeration Date	:	06/12/2009
Last Update Date	:	01/30/2024

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