Individual
JADA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 N WABASH AVE, MARION, IN 46952-2510
(765) 673-0633
Mailing address
1102 N WABASH AVE, MARION, IN 46952-2510
(765) 673-0633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12012082A
IN
1223P0221X
Pediatric Dentistry
Primary
12012082A
IN
Other
Enumeration date
07/29/2014
Last updated
12/20/2021
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