Individual
TIMOTHY DORAL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-6230
Mailing address
2750 COPPERWOOD AVE, ORANGE PARK, FL 32073-1686
(904) 239-6721
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH21341
FL
Other
Enumeration date
05/13/2022
Last updated
05/13/2022
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