Provider Demographics
NPI:1699885442
Name:ROBINSON, JOHN THOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 E 22ND
Mailing Address - Street 2:SUITE D
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2989
Mailing Address - Country:US
Mailing Address - Phone:541-342-1187
Mailing Address - Fax:541-344-1305
Practice Address - Street 1:622 E 22ND
Practice Address - Street 2:SUITE D
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2989
Practice Address - Country:US
Practice Address - Phone:541-342-1187
Practice Address - Fax:541-344-1305
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR55951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice