MEDICARE: DR. PAIGE CIARA ELSEA 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
1	1223G0001X	General Practice Dentistry	7385	NV

General Provider Information

NPI Number	:	1609494871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAIGE CIARA ELSEA DMD

Provider Business Mailing Address
First Line	:	915 ALPER CENTER DR UNIT 29306
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-1555
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9771 S EASTERN AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-6801
Country	:	US
Telephone Number	:	702-616-9655
Fax Number	:

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

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	07/14/2020

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