Organization
GARY A. ROACH, DDS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY A ROACH DDS (OWNER/PRESIDENT)
(540) 774-1019
Entity
Organization
Contact information
Practice address
5004 BRAMBLETON AVE, ROANOKE, VA 24018-4642
(540) 774-1019
(540) 774-9012
Mailing address
5004 BRAMBLETON AVE, ROANOKE, VA 24018-4642
(540) 774-1019
(540) 774-9012
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007932
VA
122300000X
Dentist
0401008066
WV
122300000X
Dentist
0401411406
PA
Other
Enumeration date
12/14/2009
Last updated
12/14/2009
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