Individual
DAVID ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
112 NE 5TH AVE, MILTON FREEWATER, OR 97862-1704
(541) 809-7043
(541) 516-4046
Mailing address
112 NE 5TH AVE, MILTON FREEWATER, OR 97862-1704
(541) 837-1699
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11295
OR
1223G0001X
General Practice Dentistry
DE60870688
WA
1223G0001X
General Practice Dentistry
DS040645
PA
Other
Enumeration date
10/15/2015
Last updated
07/03/2024
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