Roberts, Micah A

Roberts, Micah A is an individual health care provider with primary practice located at 4517 N Rockwood Dr , Peoria IL 61615-3841. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Roberts, Micah A can be contacted via phone (309) 693-0043.

Contact Information

Primary practice address
4517 N Rockwood Dr Peoria IL 61615-3841
Phone: (309) 693-0043
Fax: (309) 688-5643
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019.029023 Illinois
Dental Providers / General Practice 1223G0001X 019029023 Illinois

Profile Details

NPI number 1760746747
LBN Legal business name Roberts, Micah A
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2012
Last updated Oct 6th, 2020 - about 6 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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