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1265562235
PHILIP C ROACH
FORT WAYNE, IN
NPI
1265562235
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 12008612A)
Enumeration Date
2007-03-07
Last Update Date
2007-10-09
Business Address
-- PHILIP C ROACH D.D.S.
2121 E DUPONT RD SUITE B
FORT WAYNE, IN 46825-1546
Phone number: 260-489-1818
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Mailing Address
-- PHILIP C ROACH D.D.S.
2121 E DUPONT RD SUITE B
FORT WAYNE, IN 46825-1546
Phone number: 260-489-1818
Copy
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