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General NPI Number Information
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NPI Number | 1760659296
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Entity Type | Individual
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Provider Name | ALEX K ROH DMD, CAGS
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Gender | Male
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 655 JESSE JEWELL PKWY SE STE D
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City | GAINESVILLE
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State | GA
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Zip | 30501-3854
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Country | US
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Telephone | 770-287-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 8061 KELSEY PL
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City | JOHNS CREEK
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State | GA
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Zip | 30097-2619
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Country | US
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Telephone | 617-838-4854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN015316
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 27497
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License Number State | TX
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