MEDICARE: AC DENTAL LLC

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
1	1223G0001X	General Practice Dentistry	3691	NV

General Provider Information

NPI Number	:	1295766160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AC DENTAL LLC

Provider Business Mailing Address
First Line	:	1520 N EASTERN AVE
Second Line	:	SUITE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-1504
Country	:	US
Telephone Number	:	702-633-6339
Fax Number	:	702-644-6339

Provider Business Practice Location Address
First Line	:	1520 N EASTERN AVE
Second Line	:	SUITE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-1504
Country	:	US
Telephone Number	:	702-633-6339
Fax Number	:	702-644-6339

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. NHAN TRONG TRUONG
Credential	:	D.D.S.
Telephone Number	:	702-633-6339

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	08/22/2020

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Directions to “AC DENTAL LLC ” Practice Location

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