| J. Shane Roberts Family Dentistry | |
|
904 4th St Pleasant Grove AL 35127-1059 | |
| (205) 744-4258 | |
| (205) 744-4255 |
| Full Name | J. Shane Roberts Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 904 4th St, Pleasant Grove, Alabama |
| Authorized Official Name and Position | Jerry Shane Roberts (DENTIST) |
| Authorized Official Contact | 2057444258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Shane Roberts Family Dentistry Po Box 445 Pleasant Grove AL 35127-0445 Ph: (205) 744-4258 | J. Shane Roberts Family Dentistry 904 4th St Pleasant Grove AL 35127-1059 Ph: (205) 744-4258 |
| NPI Number | 1861910036 |
|---|---|
| Provider Enumeration Date | 09/07/2017 |
| Last Update Date | 09/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861910036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4013 (Alabama) | Primary |