Provider Demographics
NPI:1487774972
Name:ROBSON, JAMES EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:ROBSON
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:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-0309
Mailing Address - Country:US
Mailing Address - Phone:860-739-3881
Mailing Address - Fax:860-739-6754
Practice Address - Street 1:15 CHESTERFIELD RD
Practice Address - Street 2:SUITE 208
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1730
Practice Address - Country:US
Practice Address - Phone:860-739-3881
Practice Address - Fax:860-739-6754
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT83221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice