Individual
JUSTIN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 775-9150
Mailing address
401 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-2340
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7068
OK
Other
Enumeration date
06/18/2018
Last updated
08/30/2019
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