Individual
JONATHON WAYNE ROBISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1620 ST JOE RIVER DR, FORT WAYNE, IN 46805-0004
(260) 482-4202
Mailing address
1620 ST JOE RIVER DR, FORT WAYNE, IN 46805-0004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010970A
IN
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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