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NPI Code Detail

MEDICARE: MAKENZIE BELTON CRDH

MEDICARE:   MAKENZIE  BELTON  CRDH
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
1124Q00000XDental Hygienist102660NV

General Provider Information

NPI Number : 1578156295
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENZIE BELTON CRDH
Provider Business Mailing Address
First Line : 9950 W TROPICANA AVE APT 1084
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-8544
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2461 PROFESSIONAL CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0828
Country : US
Telephone Number : 702-360-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2021
Last Update Date : 02/12/2021

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Directions to “ MAKENZIE BELTON CRDH” Practice Location

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