Individual
JEFFREY BLAINE ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
BAFB DENTAL CLINIC OMS, 1067 TWINING DR, BARKSDALE AFB, LA 71110-2486
(318) 456-2743
Mailing address
1067 TWINING DR, BARKSDALE AFB, LA 71110-2486
(318) 456-2743
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D-4177
ID
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6918
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN.00205712
CO
Other
Enumeration date
10/07/2008
Last updated
09/26/2023
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