# ROBERTS FAMILY DENTAL CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265961007
- **Authorized official:** DR. ANNIE ROBERTS DDS (MEMBER)
- **Authorized official phone:** (913) 757-4429

## Contact information

- **Practice address:** 113 N BROADWAY ST, LA CYGNE, KS 66040-4205
- **Practice address phone:** (913) 757-4429
- **Mailing address:** 113 N BROADWAY ST, LA CYGNE, KS 66040-4205
- **Mailing address phone:** (913) 757-4429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 61400 | KS | Yes |

## Other

- **Enumeration date:** 06/06/2017
- **Last updated:** 07/21/2022