| Peach Tree Dental | |
|
702 N Trenton St Ruston LA 71270-3324 | |
| (318) 255-9440 | |
| (318) 251-1270 |
| Full Name | Peach Tree Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 702 N Trenton St, Ruston, Louisiana |
| Authorized Official Name and Position | Jesse Henton Roberts (OWNER/DENTIST) |
| Authorized Official Contact | 3182559440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peach Tree Dental 702 N Trenton St Ruston LA 71270-3324 Ph: (318) 255-9440 | Peach Tree Dental 702 N Trenton St Ruston LA 71270-3324 Ph: (318) 255-9440 |
| NPI Number | 1528404795 |
|---|---|
| Provider Enumeration Date | 05/15/2013 |
| Last Update Date | 05/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528404795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5205 (Louisiana) | Primary |
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