| Nevada Oms | |
|
1701 W Charleston Blvd 520 Las Vegas NV 89102-2325 | |
| (702) 750-9444 | |
| (702) 750-9442 |
| Full Name | Nevada Oms |
|---|---|
| Speciality | Dentist |
| Location | 1701 W Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Michel Daccache (OWNER) |
| Authorized Official Contact | 7027509444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nevada Oms 1701 W Charleston Blvd 520 Las Vegas NV 89102-2325 Ph: (702) 750-9444 | Nevada Oms 1701 W Charleston Blvd 520 Las Vegas NV 89102-2325 Ph: (702) 750-9444 |
| NPI Number | 1558897884 |
|---|---|
| Provider Enumeration Date | 05/05/2017 |
| Last Update Date | 05/05/2017 |
| Medicare PECOS PAC ID | 3779841168 |
|---|---|
| Medicare Enrollment ID | O20171212001751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558897884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | S2-112C (Nevada) | Primary |
| Provider Name | Michel J Daccache |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1285881243 PECOS PAC ID: 5092073494 Enrollment ID: I20171213000559 |
| Provider Name | Spencer Armuth |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194145227 PECOS PAC ID: 0446643209 Enrollment ID: I20220131002445 |
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