NPI 1144569252 PEACH TREE FOR KIDS - RUSTON, LLC RUSTON LA. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Peach Tree For Kids - Ruston, Llc - NPI: 1144569252

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Organization Name: PEACH TREE FOR KIDS - RUSTON, LLC
NPI Number: 1144569252
Entity Type Code: Organizational (2)
Authorized Official Name: JESSE HENTON ROBERTS
(OWNER/DENTIST)
Mailing Address: 206 E Vaughn Ave
Ruston
State: LA US
Postal Code: 712705926
Phone Number: 3182557760
Fax Number:
NPI Enumeration Date: 02/08/2013
NPI Last Update Date: 02/08/2013
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 1223P0221X
License Number: 5205
Healthcare Provider Taxonomy:
(Secondary)
Y
State: LA
Taxonomy Type: Dental Providers
Taxonomy Classification: Dentist
Taxonomy Specialization: Pediatric Dentistry
Taxonomy Definition:
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.


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