Provider Demographics
NPI:1689841504
Name:ROBINSON, KRIS M
Entity type:Individual
Prefix:DR
First Name:KRIS
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:KRIS
Other - Middle Name:M
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1467 N WANDA RD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5344
Mailing Address - Country:US
Mailing Address - Phone:714-538-6730
Mailing Address - Fax:
Practice Address - Street 1:1467 N WANDA RD
Practice Address - Street 2:SUITE 155
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5344
Practice Address - Country:US
Practice Address - Phone:714-538-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35161122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist