Provider Demographics
NPI:1457453797
Name:THALGOTT, ROBERT H (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:THALGOTT
Suffix:
Gender:M
Credentials:DMD, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1945 VILLAGE CENTER CIR
Mailing Address - Street 2:SUITE #110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6258
Mailing Address - Country:US
Mailing Address - Phone:702-364-5100
Mailing Address - Fax:702-364-5732
Practice Address - Street 1:1945 VILLAGE CENTER CIR
Practice Address - Street 2:SUITE #110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6258
Practice Address - Country:US
Practice Address - Phone:702-364-5100
Practice Address - Fax:702-364-5732
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1000053-2901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics