MEDICARE: ROBERT ALAN MASTHAY D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4386	CO

General Provider Information

NPI Number	:	1023017662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ALAN MASTHAY D.M.D.

Provider Business Mailing Address
First Line	:	7400 WADSWORTH BLVD STE 102
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80003-2767
Country	:	US
Telephone Number	:	303-429-1766
Fax Number	:

Provider Business Practice Location Address
First Line	:	7400 WADSWORTH BLVD STE 102
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80003-2767
Country	:	US
Telephone Number	:	303-429-1766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	06/16/2021

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