Provider Demographics
NPI:1548481096
Name:WEST, ROBERT C (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:WEST
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:1301 12TH AVE SOUTH
Mailing Address - Street 2:SUITE #204
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-761-8550
Mailing Address - Fax:406-761-5159
Practice Address - Street 1:1301 12TH AVE SOUTH
Practice Address - Street 2:SUITE #204
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-761-8550
Practice Address - Fax:406-761-5159
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT17691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics