Organization
PEACH TREE DENTAL JONESBORO, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE HENTON ROBERTS III D.D.S. (OWNER/DENTIST)
(318) 259-4161
Entity
Organization
Contact information
Practice address
602 PERSHING HWY, JONESBORO, LA 71251-2040
(318) 259-4161
(318) 259-1473
Mailing address
602 PERSHING HWY, JONESBORO, LA 71251-2040
(318) 259-4161
(318) 259-1473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3857
LA
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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