Individual
JESSICA LORRAINE ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1024 N SAN FRANCISCO, SUITE 101, FLAGSTAFF, AZ 86001
(928) 779-0385
(928) 779-6487
Mailing address
1773 W SEQUOIA DRIVE, FLAGSTAFF, AZ 86001
(928) 213-5559
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D6814
AZ
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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