| Peach Tree Dental Jonesboro, L.l.c. | |
|
602 Pershing Hwy Jonesboro LA 71251-2040 | |
| (318) 259-4161 | |
| (318) 259-1473 |
| Full Name | Peach Tree Dental Jonesboro, L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 602 Pershing Hwy, Jonesboro, Louisiana |
| Authorized Official Name and Position | Jesse Henton Roberts (OWNER/DENTIST) |
| Authorized Official Contact | 3182594161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peach Tree Dental Jonesboro, L.l.c. 602 Pershing Hwy Jonesboro LA 71251-2040 Ph: (318) 259-4161 | Peach Tree Dental Jonesboro, L.l.c. 602 Pershing Hwy Jonesboro LA 71251-2040 Ph: (318) 259-4161 |
| NPI Number | 1396198248 |
|---|---|
| Provider Enumeration Date | 07/15/2016 |
| Last Update Date | 07/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396198248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3857 (Louisiana) | Primary |