Individual
DR. GLEN ALLEN ROBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9687 BLUE CALICO DR, LAS VEGAS, NV 89123-5825
(973) 202-3272
Mailing address
9687 BLUE CALICO DR, LAS VEGAS, NV 89123-5825
(973) 202-3272
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
LL-0107-06
NV
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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