Individual
DR. RUSSELL IRVING ROBERGE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3646 E RAY ROAD, SUITE B14, PHOENIX, AZ 85044-7116
(480) 706-9009
(480) 706-1303
Mailing address
16611 S 40TH STREET, SUITE 140, PHOENIX, AZ 85048-0564
(480) 706-9009
(480) 706-1303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2939
AZ
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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