Individual
JESSE C ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2900 DOOLITTLE DR BLDG 6000, ELLSWORTH AFB, SD 57706-4821
(605) 385-3657
Mailing address
2900 DOOLITTLE DR BLDG 6000, ELLSWORTH AFB, SD 57706-4821
(605) 385-3657
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7176
NE
Other
Enumeration date
09/04/2014
Last updated
07/25/2023
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