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General NPI Number Information
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NPI Number | 1932285632
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Entity Type | Organization
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Legal Business Name | DEBBIE ROUBAL DDS, PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1819 N CIRCLE DR SUITE #1
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2430
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Country | US
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Telephone | 719-636-1933
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Fax | 719-520-0063
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Provider Business Mailing Address
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Address Line | 1819 N CIRCLE DR SUITE #1
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2430
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Country | US
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Telephone | 719-636-1933
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Fax | 719-520-0063
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBBIE ROUBAL
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Credential | DDS
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Telephone | 719-636-1933
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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 | DEN 8984
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License Number State | CO
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