Provider Demographics
NPI:1861506990
Name:ROEHRIG, ROBERT JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:ROEHRIG
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 1:245 BARCLAY CIRCLE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ROSCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5809
Mailing Address - Country:US
Mailing Address - Phone:248-852-6430
Mailing Address - Fax:248-852-7703
Practice Address - Street 1:245 BARCLAY CIRCLE
Practice Address - Street 2:SUITE 900
Practice Address - City:ROSCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5809
Practice Address - Country:US
Practice Address - Phone:248-852-6430
Practice Address - Fax:248-852-7703
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI122081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice