Individual
GARY A. ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5004 BRAMBLETON AVE, ROANOKE, VA 24018-4642
(540) 774-1019
(540) 774-9012
Mailing address
5004 BRAMBLETON AVE, ROANOKE, VA 24018-4642
(540) 774-1019
(540) 774-9012
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007932
VA
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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