Individual
DR. ANGIE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
27991 BUENA VISTA BLVD, LOS FRESNOS, TX 78566-4261
(956) 504-7275
Mailing address
27991 BUENA VISTA BLVD, LOS FRESNOS, TX 78566-4261
(956) 504-7275
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
3260
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4303260
—
OK
Enumeration date
06/05/2007
Last updated
06/24/2013
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