R Ted Roberts DDS PA

NPI #1164524328 in Clarksdale, Mississippi

Provider Information

NPI Number: 1164524328
Entity Type: Organization
Organization Name: R Ted Roberts DDS PA
Primary Specialty: Dentist
Enumeration Date: Sep 1, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 632 FRIARS POINT ROAD
City: Clarksdale
State: Mississippi
ZIP Code: 38614
Phone: (662) 624-6862

Authorized Official

Name: R TED ROBERTS, DDS PA
Title: PRESIDENT
Phone: (662) 624-6862

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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