Individual
GABRIELLE A ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
268 US HIGHWAY 62, BARDWELL, KY 42023-9095
(270) 628-3512
Mailing address
PO BOX 367, BARDWELL, KY 42023-0367
(270) 628-3512
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10879
KY
122300000X
Dentist
2021018438
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100886580
—
KY
Enumeration date
05/10/2021
Last updated
06/19/2023
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