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DR. BRIAN MARK ROBERTS DDS
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1538148085
Individual Registrant:DR. BRIAN MARK ROBERTS DDS
Gender: M
Gender: M
Location and contact information for practice:
403 DUNHAM ST MONTE VISTA, CO 81144-0403 US
Tel: 719-852-5432 Fax: --
Tel: 719-852-5432 Fax: --
Contact information for business:
PO BOX 529 MONTE VISTA, CO 81144-0529 US
Tel: 719-852-5432 Fax: --
Tel: 719-852-5432 Fax: --
Registration Information:
NPI: 1538148085
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | CO | 104946 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
