Individual
DR. BRIAN MARK ROBERTS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
403 DUNHAM ST, MONTE VISTA, CO 81144-0403
(719) 852-5432
Mailing address
PO BOX 529, MONTE VISTA, CO 81144-0529
(719) 852-5432
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104946
CO
Other
Enumeration date
01/12/2006
Last updated
07/08/2007
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