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General NPI Number Information
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NPI Number | 1639712797
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Entity Type | Organization
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Legal Business Name | DAN ROBERTS, DMD, PLLC
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 06/13/2021
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Provider Practice Location Address
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Address Line | 2335 SW 320TH ST STE 1
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City | FEDERAL WAY
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State | WA
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Zip | 98023-2569
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Country | US
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Telephone | 253-661-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 2603 110TH AVE E
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City | EDGEWOOD
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State | WA
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Zip | 98372-1846
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Country | US
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Telephone | 425-890-7155
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DAN ROBERTS
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Credential |
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Telephone | 425-890-7155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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