Organization
GENERAL DENTISTRY 4 KIDS-KOLB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD ROBERTS DMD (OWNER)
(480) 607-9999
Entity
Organization
Contact information
Practice address
5861 N ORACLE RD, TUCSON, AZ 85704-3813
(520) 209-1608
Mailing address
1426 W PRINCE RD, TUCSON, AZ 85705-3014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4964
AZ
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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