Roach, Brandi Rachelle

Roach, Brandi Rachelle is an individual health care provider with primary practice located at 2707 W Huntsville Ave , Springdale AR 72762-7723. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Roach, Brandi Rachelle can be contacted via phone (479) 756-8631.

Contact Information

Primary practice address
2707 W Huntsville Ave Springdale AR 72762-7723
Phone: (479) 756-8631
Fax: (479) 751-7892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3363 Arkansas

Profile Details

NPI number 1598840340
LBN Legal business name Roach, Brandi Rachelle
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598840340 NPPES
Arkansas Other 3363 DELTA
Arkansas Other 58250 DELTA
Arkansas MEDICAID 1317596 DELTA

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