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General NPI Number Information
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NPI Number | 1386874691
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Entity Type | Individual
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Provider Name | JOYCE MONIQUE ROBERTS D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2009
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Last Update Date | 07/21/2009
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Provider Practice Location Address
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Address Line | 615 W OGLETHORPE HWY
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City | HINESVILLE
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State | GA
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Zip | 31313-4485
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Country | US
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Telephone | 912-877-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 BEVERLY AVE
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City | ALBANY
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State | GA
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Zip | 31705-1405
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Country | US
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Telephone | 706-339-2705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN013949
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License Number State | GA
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