Individual
CORA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DHAT
Contact information
Practice address
201 3RD AVENUE, SUITE 115, SEWARD, AK 99664
(907) 224-4925
(907) 224-4933
Mailing address
PO BOX 103, HOONAH, AK 99829-0103
(907) 945-3235
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
13-114-DHAT
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1603850
—
AK
Enumeration date
11/08/2013
Last updated
01/09/2019
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