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NPI Code Detail

MEDICARE: DR. LUIZ ALFREDO DOS SANTOS DMD

MEDICARE:  DR. LUIZ ALFREDO DOS SANTOS  DMD
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
11223G0001XGeneral Practice Dentistry5058NV

General Provider Information

NPI Number : 1235250796
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUIZ ALFREDO DOS SANTOS DMD
Provider Business Mailing Address
First Line : 1350 S JONES BLVD STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1233
Country : US
Telephone Number : 702-870-6161
Fax Number : 702-870-2302
Provider Business Practice Location Address
First Line : 1350 S JONES BLVD STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1206
Country : US
Telephone Number : 702-870-6161
Fax Number : 702-648-7343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 11/09/2018

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Directions to “ DR. LUIZ ALFREDO DOS SANTOS DMD” Practice Location

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