Provider Demographics
NPI:1679617500
Name:HARKINS, ROBERT M (ROBERT M HARKINS DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:HARKINS
Suffix:
Gender:M
Credentials:ROBERT M HARKINS DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543C HIGHWAY 80 W
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-4193
Mailing Address - Country:US
Mailing Address - Phone:601-924-8600
Mailing Address - Fax:601-924-8622
Practice Address - Street 1:543C HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4193
Practice Address - Country:US
Practice Address - Phone:601-924-8600
Practice Address - Fax:601-924-8622
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2077-84122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist