MEDICARE: DR. JAMES B POLLEY D.D.S.

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	2354	NV

General Provider Information

NPI Number	:	1528237476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES B POLLEY D.D.S.

Provider Business Mailing Address
First Line	:	1875 VILLAGE CENTER CIR
Second Line	:	#110
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6369
Country	:	US
Telephone Number	:	702-873-0324
Fax Number	:	702-873-6368

Provider Business Practice Location Address
First Line	:	1875 VILLAGE CENTER CIR
Second Line	:	#110
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6369
Country	:	US
Telephone Number	:	702-873-0324
Fax Number	:	702-873-6368

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	02/23/2023

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