Organization
PEDIATRIC DENTISTRY & INTERCEPTIVE ORTHODONTICS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD ROBISON D.D.S. (TREASURER)
(315) 637-6961
Entity
Organization
Contact information
Practice address
8016 E GENESEE ST, FAYETTEVILLE, NY 13066-9692
(315) 637-6961
(315) 637-0169
Mailing address
8016 E GENESEE ST, FAYETTEVILLE, NY 13066-9692
(315) 637-6961
(315) 637-0169
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
027300
NY
1223P0221X
Pediatric Dentistry
038405
NY
1223P0221X
Pediatric Dentistry
043434
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
050957
NY
Other
Enumeration date
12/11/2006
Last updated
09/11/2025
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