Provider Demographics
NPI:1962189043
Name:ROBLES, CHRISTIAN ADRIAN (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ADRIAN
Last Name:ROBLES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29W300 POMEROY ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-3663
Mailing Address - Country:US
Mailing Address - Phone:630-559-5213
Mailing Address - Fax:
Practice Address - Street 1:2853 E NEW YORK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9059
Practice Address - Country:US
Practice Address - Phone:630-449-3079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001258-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist