Provider Demographics
NPI:1760566533
Name:ROUBAL, DEBBIE (DDS)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:ROUBAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 E SOUTH BOULDER RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1345
Mailing Address - Country:US
Mailing Address - Phone:303-665-8228
Mailing Address - Fax:303-200-7375
Practice Address - Street 1:4155 DARLEY AVE STE C
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6536
Practice Address - Country:US
Practice Address - Phone:303-499-7072
Practice Address - Fax:303-200-7375
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN8984122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist