Organization
COREY A. ROBERTSON, DDS A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL R PERRY (MANAGER)
(252) 520-3241
Entity
Organization
Contact information
Practice address
3203 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-2220
(225) 201-0511
Mailing address
3203 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-2220
(225) 201-0511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4907
LA
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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