Provider Demographics
NPI:1841405917
Name:ROWE, KRISTY ROBERTS (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:ROBERTS
Last Name:ROWE
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 1:2850 BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7236
Mailing Address - Country:US
Mailing Address - Phone:870-932-4126
Mailing Address - Fax:870-932-4042
Practice Address - Street 1:2850 BROWNS LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7236
Practice Address - Country:US
Practice Address - Phone:870-932-4126
Practice Address - Fax:870-932-4042
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR33411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice