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NPI Code Detail

MEDICARE: WARM SPRINGS DENTAL LLC

MEDICARE: WARM SPRINGS 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
11223G0001XGeneral Practice Dentistry10386NV

General Provider Information

NPI Number : 1669524500
Entity Type Code : Organization
Provider Name (Legal Business Name) : WARM SPRINGS DENTAL LLC
Provider Business Mailing Address
First Line : 1525 W WARM SPRINGS RD
Second Line : SUITE #100
City : HENDERSON
State : NV
Zip : 89014-4316
Country : US
Telephone Number : 702-454-0818
Fax Number : 702-454-3716
Provider Business Practice Location Address
First Line : 1525 W WARM SPRINGS RD
Second Line : SUITE #100
City : HENDERSON
State : NV
Zip : 89014-4316
Country : US
Telephone Number : 702-454-0818
Fax Number : 702-454-3716
Authorized Official
Title or Position : OFFICER IN CORPORATION
Name : DR. ROBERT WILFORD NISSON
Credential : DDS
Telephone Number : 702-454-0818
Provider Enumeration Date : 01/18/2007
Last Update Date : 08/22/2020

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Directions to “WARM SPRINGS DENTAL LLC ” Practice Location

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