Healthcare Provider Details

I. General information

NPI: 1255647525
Provider Name (Legal Business Name): EDWARD ROBERTS III D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 PLEASANT ST STE 102-103
FALL RIVER MA
02723-1000
US

IV. Provider business mailing address

198 DEXTER ST
ATTLEBORO MA
02703-5192
US

V. Phone/Fax

Practice location:
  • Phone: 774-271-5936
  • Fax:
Mailing address:
  • Phone: 508-561-8681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1855537
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: