Provider Demographics
NPI:1982815882
Name:ROBERTS, THOMAS LUTHER IV (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LUTHER
Last Name:ROBERTS
Suffix:IV
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1915 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2104
Mailing Address - Country:US
Mailing Address - Phone:828-687-0872
Mailing Address - Fax:828-681-8184
Practice Address - Street 1:1915 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2104
Practice Address - Country:US
Practice Address - Phone:828-687-0872
Practice Address - Fax:828-681-8184
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics