| Roanoke Family Dentistry | |
|
1405 Cannon Pkwy Roanoke TX 76262-3620 | |
| (817) 430-1212 | |
| (817) 491-0154 |
| Full Name | Roanoke Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1405 Cannon Pkwy, Roanoke, Texas |
| Authorized Official Name and Position | Kimberley Anne Baker (PRESIDENT) |
| Authorized Official Contact | 8174301212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roanoke Family Dentistry 1405 Cannon Pkwy Roanoke TX 76262-3620 Ph: (817) 430-1212 | Roanoke Family Dentistry 1405 Cannon Pkwy Roanoke TX 76262-3620 Ph: (817) 430-1212 |
| NPI Number | 1750314761 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 03/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750314761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19129 (Texas) | Primary |
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