Individual
DR. ROGER DALE BROOKS, JR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
402 E PARKWAY DR, RUSSELLVILLE, AR 72801-4103
(479) 890-6174
(479) 967-0339
Mailing address
402 E PARKWAY DR, RUSSELLVILLE, AR 72801-4103
(479) 890-6174
(479) 967-0339
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3667
AR
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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