Provider Demographics
NPI:1336369123
Name:ROBLEE, RICHARD DAVID (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVID
Last Name:ROBLEE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E SUNBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2830
Mailing Address - Country:US
Mailing Address - Phone:479-521-6060
Mailing Address - Fax:479-521-4161
Practice Address - Street 1:162 E SUNBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2830
Practice Address - Country:US
Practice Address - Phone:479-521-6060
Practice Address - Fax:479-521-4161
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142421223X0400X
AR27201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR887681OtherUNITED CONCORDIA ID
AR5F054OtherBCBS GROUP ID
OK200046140 AMedicaid
AR155641608Medicaid
OK200046150 AMedicaid
AR58127OtherRDR BCBS ID