Individual
DR. JOHN LEO MILLEN ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
PHS INDIAN HOSPITAL, HIGHWAY 1, RED LAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Mailing address
1810 S LAKE IRVING DR SW, BEMIDJI, MN 56601-8856
(218) 444-7817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901011626
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302T0RO
BLUE CROSS/BLUE SHIELD MN
MN
Enumeration date
09/15/2006
Last updated
07/09/2007
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