# ROBERSON FAMILY DENTAL PLLC

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

## Provider details

- **NPI number:** 1548761711
- **Authorized official:** DR. MARTIN WILLIS ROBERSON SR. DDS (PRESIDENT)
- **Authorized official phone:** (504) 452-5122

## Contact information

- **Practice address:** 1740 BIG SPRINGS RD, MARYVILLE, TN 37801-8206
- **Practice address phone:** (865) 681-7645
- **Mailing address:** 2001 CAWOOD FALLS LN, KNOXVILLE, TN 37931-4065
- **Mailing address phone:** (504) 452-5122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 8949 | TN | Yes |

## Other

- **Enumeration date:** 02/23/2018
- **Last updated:** 02/23/2018