David Henry DDS and Randell Roark DDS Inc.

NPI #1497169932 in Mansfield, Ohio

Provider Information

NPI Number: 1497169932
Entity Type: Organization
Organization Name: David Henry DDS and Randell Roark DDS Inc.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 12, 2014
Last Updated: Jun 12, 2014

Practice Location

Address: 1041 CRICKET LN
City: Mansfield
State: Ohio
ZIP Code: 44906-4105
Phone: (419) 526-4249

Authorized Official

Name: DR. RANDELL SCOTT ROARK, DDS
Title: DENTIST/ VICE PRESIDENT
Phone: (910) 584-6894

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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