Provider Demographics
NPI:1972940302
Name:MYERS, ROBIN ALLISON (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ALLISON
Last Name:MYERS
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 1:45 FORESTWOOD DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6213
Mailing Address - Country:US
Mailing Address - Phone:570-524-4050
Mailing Address - Fax:570-524-4450
Practice Address - Street 1:45 FORESTWOOD DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6213
Practice Address - Country:US
Practice Address - Phone:570-524-4050
Practice Address - Fax:570-524-4450
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029274L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist