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NPI Code Detail

MEDICARE: DR. RENE WELCH ROBERTS D.M.D.

MEDICARE: DR. RENE WELCH ROBERTS D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN011640GA
21223G0001XGeneral Practice DentistryDN011640GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12161791-UUOTHERGAEMPLOYER STATE ID #

General Provider Information

NPI Number : 1134269699
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENE WELCH ROBERTS D.M.D.
Provider Business Mailing Address
First Line : 2751 WARM SPRINGS RD
Second Line : SUITE B
City : COLUMBUS
State : GA
Zip : 31904-6858
Country : US
Telephone Number : 706-494-2679
Fax Number : 706-494-2697
Provider Business Practice Location Address
First Line : 2751 WARM SPRINGS RD
Second Line : SUITE B
City : COLUMBUS
State : GA
Zip : 31904-6858
Country : US
Telephone Number : 706-494-2679
Fax Number : 706-494-2697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 01/17/2012

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