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General NPI Number Information
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NPI Number | 1831684513
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Entity Type | Individual
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Provider Name | MACKENZIE ROBLEE DDS
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Gender | Female
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 3484 W WEDINGTON DR STE 7
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-7164
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Country | US
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Telephone | 479-348-2348
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Fax |
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Provider Business Mailing Address
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Address Line | 5518 W WALSH LN
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City | ROGERS
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State | AR
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Zip | 72758-8947
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 4486
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License Number State | AR
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