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NPI Code Detail

MEDICARE: SAOLY BENSON DDS MS PROF. CORP.

MEDICARE: SAOLY BENSON DDS MS PROF. CORP.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryS3-272NV

General Provider Information

NPI Number : 1003214305
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAOLY BENSON DDS MS PROF. CORP.
Provider Business Mailing Address
First Line : 1452 W HORIZON RIDGE PKWY # 653
Second Line :
City : HENDERSON
State : NV
Zip : 89012-4422
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5980 S DURANGO DR STE 124
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1775
Country : US
Telephone Number : 702-800-4698
Fax Number :
Authorized Official
Title or Position : ORTHODONTIST
Name : DR. SAOLY BENSON
Credential : D.D.S., M.S.
Telephone Number : 253-985-3120
Provider Enumeration Date : 12/18/2014
Last Update Date : 12/19/2024

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