Individual
DR. HOWARD LAMAR ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
60024 OLIVE ST, SMITHVILLE, MS 38870-9719
(662) 651-7111
(662) 651-7115
Mailing address
PO BOX 1697, GRENADA, MS 38902-1697
(662) 614-5070
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1912-80
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064850
—
MS
Enumeration date
02/12/2007
Last updated
07/17/2012
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