| NPI | 1144569252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE HENTON ROBERTS Owner/Dentist 318-255-7760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 5205) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |