Individual
FOREST RICHARD ROBERTSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
515 S ILLINOIS ST, MONTICELLO, IN 47960
(574) 583-5100
Mailing address
801 S MAIN ST, MONTICELLO, IN 47960-2532
(574) 583-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7653
IN
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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