Provider Demographics
NPI:1790822286
Name:ROBLESGIL, BERNARDO (DDS)
Entity Type:Individual
Prefix:
First Name:BERNARDO
Middle Name:
Last Name:ROBLESGIL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 SEA CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-1638
Mailing Address - Country:US
Mailing Address - Phone:832-217-0961
Mailing Address - Fax:
Practice Address - Street 1:1004 W STERLING ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-4201
Practice Address - Country:US
Practice Address - Phone:281-422-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211651223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery