Provider Demographics
NPI:1306938220
Name:MOYER, ROBYN L (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:L
Last Name:MOYER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 OCEAN AVE.
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1615
Mailing Address - Country:US
Mailing Address - Phone:415-585-4200
Mailing Address - Fax:415-585-4222
Practice Address - Street 1:2665 OCEAN AVE.
Practice Address - Street 2:SUITE B
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1615
Practice Address - Country:US
Practice Address - Phone:415-585-4200
Practice Address - Fax:415-585-4222
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice