Provider Demographics
NPI:1134965072
Name:ROBERTI, KRISTINA (DMD)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:
Last Name:ROBERTI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:MCCANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:451 NW 87TH LN APT 102
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6540
Mailing Address - Country:US
Mailing Address - Phone:352-410-2701
Mailing Address - Fax:
Practice Address - Street 1:2021 E COMMERCIAL BLVD STE 208
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3754
Practice Address - Country:US
Practice Address - Phone:855-381-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist