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6365 Simmons St #100 N Las Vegas NV 89031-7292 | |
| (702) 853-7322 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6365 Simmons St, N Las Vegas, Nevada |
| Authorized Official Name and Position | William Franklin Waggoner (OWNER, PRESIDENT) |
| Authorized Official Contact | 7028537322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6365 Simmons St #100 N Las Vegas NV 89031-7292 Ph: (702) 853-7322 | 6365 Simmons St #100 N Las Vegas NV 89031-7292 Ph: (702) 853-7322 |
| NPI Number | 1104055037 |
|---|---|
| Provider Enumeration Date | 07/13/2009 |
| Last Update Date | 07/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104055037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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