Healthcare Provider Details

I. General information

NPI: 1093384356
Provider Name (Legal Business Name): KALIN MCCABE ROACH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25299 CANAL RD STE A5
ORANGE BEACH AL
36561-5801
US

IV. Provider business mailing address

25299 CANAL RD STE A5
ORANGE BEACH AL
36561-5801
US

V. Phone/Fax

Practice location:
  • Phone: 251-321-7575
  • Fax:
Mailing address:
  • Phone: 601-395-6017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0006984-C1
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: