Provider Demographics
NPI:1659764405
Name:ROBERTS, CHRIS (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 W MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1770
Mailing Address - Country:US
Mailing Address - Phone:419-423-1452
Mailing Address - Fax:
Practice Address - Street 1:1619 W MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1770
Practice Address - Country:US
Practice Address - Phone:419-423-1452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0183951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics