Provider Demographics
NPI:1831684513
Name:ROBLEE, MACKENZIE (DDS)
Entity type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:
Last Name:ROBLEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:
Other - Last Name:YOUNGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5518 W WALSH LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3484 W WEDINGTON DR STE 7
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-7164
Practice Address - Country:US
Practice Address - Phone:479-348-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist