Provider Demographics
NPI:1215150743
Name:ROBINSON, LANCE A (DDS)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W LA VETA AVE
Mailing Address - Street 2:301
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4213
Mailing Address - Country:US
Mailing Address - Phone:714-771-7300
Mailing Address - Fax:
Practice Address - Street 1:1201 W LA VETA AVE
Practice Address - Street 2:301
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4213
Practice Address - Country:US
Practice Address - Phone:714-771-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice