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NPI Code Detail

MEDICARE: ROBERT C SCHALLER JR. DDS

MEDICARE: ROBERT C SCHALLER JR. DDS
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
11223G0001XGeneral Practice Dentistry5043TNV

General Provider Information

NPI Number : 1225244148
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT C SCHALLER JR. DDS
Provider Business Mailing Address
First Line : 5001 E BONANZA RD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-3560
Country : US
Telephone Number : 702-307-2273
Fax Number :
Provider Business Practice Location Address
First Line : 5001 E BONANZA RD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-3560
Country : US
Telephone Number : 702-307-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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