| J Keith Roberts DDS LLC | |
|
828 S Auto Mall Rd Bloomington IN 47401-5430 | |
| (812) 333-5437 | |
| (812) 333-6305 |
| Full Name | J Keith Roberts DDS LLC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 828 S Auto Mall Rd, Bloomington, Indiana |
| Authorized Official Name and Position | J Keith Roberts (OWNER) |
| Authorized Official Contact | 8123335437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J Keith Roberts DDS LLC 828 S Auto Mall Rd Bloomington IN 47401-5430 Ph: (812) 333-5437 | J Keith Roberts DDS LLC 828 S Auto Mall Rd Bloomington IN 47401-5430 Ph: (812) 333-5437 |
| NPI Number | 1518290550 |
|---|---|
| Provider Enumeration Date | 09/09/2009 |
| Last Update Date | 02/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518290550 | NPI | - | NPPES |
| 100060010A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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