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Individual

DR. LANCE KELVIN ROBERTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1170 N. MOAPA VALLEY BLVD., SUITE A, OVERTON, NV 89040
(702) 397-8844
Mailing address
PO BOX 839, OVERTON, NV 89040-0839
(702) 397-8844

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2109
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00-186235
EIN
NV
Enumeration date
07/05/2006
Last updated
07/08/2007
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