| NPI | 1528404795 |
|---|---|
| Doing Business As | PEACH TREE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JESSE HENTON ROBERTS Owner/Dentist 318-255-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5205) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |