Peach Tree For Kids - Ruston, Llc
Pediatric Dentist in Ruston, LA(View on Map)
Legal Business Name
Peach Tree For Kids - Ruston, Llc
NPI Number
1144569252
NPI Type
Organization
Enumeration Date
02/08/2013
Specialties
(Taxonomies)Licenses
State
Louisiana
License Number
5205
Contact
Information
Purpose
Mailing
Location
Address
702 N TRENTON ST
206 E VAUGHN AVE
City
Ruston
Ruston
State
LA
LA
Postal Code
71270-3324
71270-5926
Country
US
US
Telephone Number
(318) 255-9440
(318) 255-7760
Authorized Official
Name
Jesse Roberts
Title or Position
OWNER/DENTIST
Telephone Number
(318) 255-7760
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/08/2013