|
| |
|
375 N Stephanie St Bldg 6 Suite 611 Henderson NV 89014-8771 | |
| (702) 990-7336 | |
| (702) 990-7340 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 375 N Stephanie St Bldg 6, Henderson, Nevada |
| Authorized Official Name and Position | Daniel William Sims (CEO) |
| Authorized Official Contact | 7029907336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
375 N Stephanie St Bldg 6 Suite 611 Henderson NV 89014-8771 Ph: (702) 990-7336 | 375 N Stephanie St Bldg 6 Suite 611 Henderson NV 89014-8771 Ph: (702) 990-7336 |
| NPI Number | 1003939810 |
|---|---|
| Provider Enumeration Date | 04/08/2007 |
| Last Update Date | 09/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003939810 | NPI | - | NPPES |
| 002202052 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | S6-19 (Nevada) | Primary |
Valudental Sunset Boyd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 W Sunset Rd Ste 7, Henderson, NV 89014 Phone: 702-674-7000 | |