| NPI | 1396198248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE HENTON ROBERTS Owner/Dentist 318-259-4161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3857) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |