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2301 E Lake Mead Blvd N Las Vegas NV 89030-7137 | |
| (702) 649-9333 | |
| (702) 639-0579 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2301 E Lake Mead Blvd, N Las Vegas, Nevada |
| Authorized Official Name and Position | Benny Kohanteb (OWNER) |
| Authorized Official Contact | 7022182713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2301 E Lake Mead Blvd N Las Vegas NV 89030-7137 Ph: (702) 649-9333 | 2301 E Lake Mead Blvd N Las Vegas NV 89030-7137 Ph: (702) 649-9333 |
| NPI Number | 1104912831 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104912831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4509T (Nevada) | Primary |
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