Individual
RONAL ROBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
203 S MARKET ST, CHARLESTON, MS 38921-2236
(662) 647-8442
(662) 647-3559
Mailing address
PO BOX 337, CHARLESTON, MS 38921-0337
(662) 647-8442
(662) 647-3559
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1943-81
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064888
—
MS
Enumeration date
08/08/2006
Last updated
07/08/2007
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