Individual
DR. BRYAN PATRICK ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
ADVANCED EDUCATION IN GENERAL DENTISTRY PROGRAM, 2300 RAMSEY ST., FAYETTEVILLE, NC 28301-3856
(910) 822-7029
(910) 482-5050
Mailing address
ADVANCED EDUCATION IN GENERAL DENTISTRY PROGRAM, 2300 RAMSEY ST., FAYETTEVILLE, NC 28301-3856
(910) 822-7029
(910) 482-5050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8774
NC
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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