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3896 N Martin Luther King Blvd N Las Vegas NV 89032-6603 | |
| (702) 614-1792 | |
| (702) 933-0190 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3896 N Martin Luther King Blvd, N Las Vegas, Nevada |
| Authorized Official Name and Position | Shannon K Lee (OWNER) |
| Authorized Official Contact | 7026141792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | 3896 N Martin Luther King Blvd N Las Vegas NV 89032-6603 Ph: (702) 614-1792 |
| NPI Number | 1952497984 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 05/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952497984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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