Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2596 | SC |
NPI | 1003158023 |
---|---|
Provider Name | Dr. Christopher Robnett |
First Address | Columbia, SC 29223-6902 |
Second Address | Columbia, SC 29223-6902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 18/03/2013 |