Organization
ROBERTS DENTAL RANCH OF TEXAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAENIE OAKES ROBERTS DDS (CO-DIRECTOR)
(214) 728-9419
Entity
Organization
Contact information
Practice address
2440 EAST PROSPER TRAIL, PROSPER, TX 75078
(972) 347-6444
Mailing address
1921 STILLHOUSE HOLLOW DR, PROSPER, TX 75078-7203
(972) 347-6444
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22822
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
21466
TX
Other
Enumeration date
02/09/2009
Last updated
02/09/2009
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