Provider Demographics
NPI:1821010125
Name:GLANDT, ROBERT CHRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHRIS
Last Name:GLANDT
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 1:2613 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1751
Mailing Address - Country:US
Mailing Address - Phone:308-632-3666
Mailing Address - Fax:308-635-9705
Practice Address - Street 1:2613 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1751
Practice Address - Country:US
Practice Address - Phone:308-632-3666
Practice Address - Fax:308-635-9705
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE41961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice