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Individual
DR. BRIAN DAVID ROBERTS
Active
Individual
DR. BRIAN DAVID ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5151
WA
1223G0001X
General Practice Dentistry
Primary
8192
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5038930
DSHS
WA
01
—
606932
UNITED CONCORDIA
WA
Enumeration date
09/19/2007
Last updated
09/19/2007
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