Provider Demographics
NPI:1780728287
Name:ROBERTS, DONALD LAWRENCE (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LAWRENCE
Last Name:ROBERTS
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 1:3723 HARPER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3621
Mailing Address - Country:US
Mailing Address - Phone:713-666-5819
Mailing Address - Fax:
Practice Address - Street 1:5177 RICHMOND AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6707
Practice Address - Country:US
Practice Address - Phone:713-960-9926
Practice Address - Fax:713-626-2927
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11,1241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice