Provider Demographics
NPI:1962598953
Name:WOOD, ROBIN F (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:F
Last Name:WOOD
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 1:909 E CENTENNIAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6601
Mailing Address - Country:US
Mailing Address - Phone:620-232-1000
Mailing Address - Fax:620-232-1019
Practice Address - Street 1:909 E CENTENNIAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6601
Practice Address - Country:US
Practice Address - Phone:620-232-1000
Practice Address - Fax:620-232-1019
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS601041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS116626OtherBCBS PROVIDER NO.