Organization
RONALD G. ROBERTS, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD GLENN ROBERTS D.D.S. (OWNER)
(479) 738-2777
Entity
Organization
Contact information
Practice address
409 CHURCH AVENUE, HUNTSVILLE, AR 72740-0249
(479) 738-2777
(479) 738-2705
Mailing address
PO BOX 249, 409 CHURCH AVENUE, HUNTSVILLE, AR 72740-0249
(479) 738-2777
(479) 738-2705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366543779
NPI # PERSONAL
—
05
—
162357608
—
AR
Enumeration date
12/18/2008
Last updated
12/18/2008
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