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5465 Simmons St Suite 4 North Las Vegas NV 89031-9000 | |
| (702) 638-1005 | |
| (702) 638-1071 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 5465 Simmons St, North Las Vegas, Nevada |
| Authorized Official Name and Position | Pamela K Propster (OFFICE MANAGER) |
| Authorized Official Contact | 7026381005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5465 Simmons St Suite 4 North Las Vegas NV 89031-9000 Ph: (702) 638-1005 | 5465 Simmons St Suite 4 North Las Vegas NV 89031-9000 Ph: (702) 638-1005 |
| NPI Number | 1760795256 |
|---|---|
| Provider Enumeration Date | 07/26/2010 |
| Last Update Date | 07/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760795256 | NPI | - | NPPES |
| 100510098 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4348 (Nevada) | Primary |
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