Provider Demographics
NPI:1487092003
Name:ROBINSON, LOREN (DMD)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PARK ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MS
Mailing Address - Zip Code:39365-2130
Mailing Address - Country:US
Mailing Address - Phone:601-774-8252
Mailing Address - Fax:601-774-7230
Practice Address - Street 1:101 PARK ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-2130
Practice Address - Country:US
Practice Address - Phone:601-774-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3702-13122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist