Provider Demographics
NPI:1104907658
Name:ROBINSON-HARPER, CONNIE A (DDS)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:A
Last Name:ROBINSON-HARPER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:A
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5220 CLARK AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2618
Mailing Address - Country:US
Mailing Address - Phone:562-867-7727
Mailing Address - Fax:562-867-2117
Practice Address - Street 1:5220 CLARK AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2618
Practice Address - Country:US
Practice Address - Phone:562-867-7727
Practice Address - Fax:562-867-2117
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice