Provider Demographics
NPI:1518027093
Name:FLATH, ROBERT K (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:FLATH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 HILLTOP DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901
Mailing Address - Country:US
Mailing Address - Phone:307-362-4867
Mailing Address - Fax:
Practice Address - Street 1:1208 HILLTOP DR
Practice Address - Street 2:SUITE 209
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901
Practice Address - Country:US
Practice Address - Phone:307-362-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT31158399211223P0300X, 1223E0200X
WY10221223P0300X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223P0300XDental ProvidersDentistPeriodontics