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General NPI Number Information
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NPI Number | 1366689093
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Entity Type | Organization
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Legal Business Name | T. LUKE ROBERTS, DMD, MSD, PA
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 2 WALDEN RIDGE DRIVE SUITE 50
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City | ASHEVILLE
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State | NC
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Zip | 28803
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Country | US
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Telephone | 828-687-0872
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Fax |
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Provider Business Mailing Address
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Address Line | 2 WALDEN RIDGE DRIVE SUITE 50
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City | ASHEVILLE
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State | NC
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Zip | 28803
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Country | US
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Telephone | 828-687-0872
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ORTHODONTIST
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Name | DR. THOMAS LUTHER ROBERTS IV
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Credential | D.M.D., M.S.D.
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Telephone | 828-687-0872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 8102
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License Number State | NC
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