Dentalville | |
7101 W Craig Rd #102 Los Vegas NV 89129-6059 | |
(702) 515-0955 | |
(702) 515-0558 |
Full Name | Dentalville |
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Speciality | Dentist |
Location | 7101 W Craig Rd, Los Vegas, Nevada |
Authorized Official Name and Position | Monique R Glosman (CHIEF OF STAFF) |
Authorized Official Contact | 3104802307 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dentalville 833 W Whittier Blvd Montebello CA 90640-4735 Ph: (323) 266-1000 | Dentalville 7101 W Craig Rd #102 Los Vegas NV 89129-6059 Ph: (702) 515-0955 |
NPI Number | 1790966133 |
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Provider Enumeration Date | 11/14/2007 |
Last Update Date | 06/06/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790966133 | NPI | - | NPPES |
100512442 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 3850 (Nevada) | Secondary |
122300000X | Dentist | 3580 (Nevada) | Primary |