Individual
DR. JONATHAN MATTHEW ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2121 25TH STREET, SUITE 2, COLUMBUS, IN 47201-3214
(812) 379-9561
(812) 372-8157
Mailing address
2121 25TH STREET, SUITE 2, COLUMBUS, IN 47201-3214
(812) 379-9561
(812) 372-8157
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008327
IN
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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