| Gary A. Roach, Dds, Ltd | |
|
5004 Brambleton Ave Roanoke VA 24018-4642 | |
| (540) 774-1019 | |
| (540) 774-9012 |
| Full Name | Gary A. Roach, Dds, Ltd |
|---|---|
| Speciality | Dentist |
| Location | 5004 Brambleton Ave, Roanoke, Virginia |
| Authorized Official Name and Position | Gary A Roach (OWNER/PRESIDENT) |
| Authorized Official Contact | 5407741019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary A. Roach, Dds, Ltd 5004 Brambleton Ave Roanoke VA 24018-4642 Ph: (540) 774-1019 | Gary A. Roach, Dds, Ltd 5004 Brambleton Ave Roanoke VA 24018-4642 Ph: (540) 774-1019 |
| NPI Number | 1093044406 |
|---|---|
| Provider Enumeration Date | 12/14/2009 |
| Last Update Date | 12/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093044406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401007932 (Virginia) | Primary |
| 122300000X | Dentist | 0401411406 (Pennsylvania) | Secondary |
| 122300000X | Dentist | 0401008066 (West Virginia) | Secondary |
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