Healthcare Provider Details

I. General information

NPI: 1477470581
Provider Name (Legal Business Name): KAITLIN MARIE ROBERTS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

674 BLVD DE FRANCE MCRD PARRIS ISLAND DENTAL CLINIC
PARRIS ISLAND SC
29905
US

IV. Provider business mailing address

674 BLVD DE FRANCE MCRD PARRIS ISLAND DENTAL CLINIC
PARRIS ISLAND SC
29905
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-3500
  • Fax:
Mailing address:
  • Phone: 843-228-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14294990
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: