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DR. BRIAN MARK ROBERTS DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1538148085

Individual Registrant:
DR. BRIAN MARK ROBERTS DDS
Gender: M

Location and contact information for practice:
403 DUNHAM ST  MONTE VISTA, CO 81144-0403 US
Tel: 719-852-5432  Fax: --

Contact information for business:
PO BOX 529  MONTE VISTA, CO 81144-0529 US
Tel: 719-852-5432  Fax: --

Registration Information:
NPI: 1538148085
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CO104946

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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