Provider Demographics
NPI:1750432761
Name:BATTAGLIN, ROBERTO G (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:G
Last Name:BATTAGLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 RUSTIC CLUB WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5201
Mailing Address - Country:US
Mailing Address - Phone:702-624-2569
Mailing Address - Fax:
Practice Address - Street 1:7720 W SAHARA AVE STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2754
Practice Address - Country:US
Practice Address - Phone:702-862-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5125122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist