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Individual

MICHAEL AUSTIN ROBERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2730 COUNTRY CLUB RD STE A, LUCAS, TX 75002-8781
(972) 363-8020
(972) 363-8024
Mailing address
2730 COUNTRY CLUB RD STE A, LUCAS, TX 75002-8781
(972) 363-8020
(972) 363-8024

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
23852
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23852
TX

Other

Enumeration date
01/25/2012
Last updated
05/22/2019
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