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Dr. John Boone Roberson SR.
Oral and Maxillofacial Surgery (Dentist) in Hattiesburg, Mississippi
NPI 1871607812

John Boone Roberson SR. is a Oral and Maxillofacial Surgery (Dentist) based in Hattiesburg, MS and is specialized in Oral and Maxillofacial Surgery. John Boone Roberson SR. practices in Hattiesburg, MS. The NPI Number for John Boone Roberson SR. is 1871607812 and holds a License No. 274693 (Mississippi).

The current practice location address for John Boone Roberson SR. is 811 South 28Th Avenue, Hattiesburg, MS and can be reached out via phone at 601-261-2611 and via fax at 601-261-2711. You can also correspond with John Boone Roberson SR. through the mailing address at 811 SOUTH 28TH AVENUE, HATTIESBURG, MS - 39402 (mailing address contact number: 601-261-2611).

Location: 811 South 28Th Avenue, Hattiesburg, MS, 39402
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Provider Profile Details
NPI Number
1871607812
Provider Name
John Boone Roberson SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
811 South 28Th Avenue, Hattiesburg, MS, 39402
Phone Number
601-261-2611
Fax Number
601-261-2711
Provider Enumeration Date
08/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00660451 05 MS
01951327 05 MS
institution
Provider Business Practice Location Address Details
Address
811 South 28Th Avenue
City
State
Zip
39402
Phone Number
601-261-2611
Fax Number
601-261-2711
person
Provider Business Mailing Address Details
Address
811 South 28Th Avenue
City
State
Zip
39402
Phone Number
601-261-2611
Fax Number
601-261-2711
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
274693 (Mississippi)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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