# DR. JOHN BOONE ROBERSON SR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871607812
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 274693 | MS | Yes |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 03/07/2012
