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NPI Code Detail

MEDICARE: DR. ERNESTO BARBOSA DMD

MEDICARE:  DR. ERNESTO  BARBOSA  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
1122300000XDentist6060NV

General Provider Information

NPI Number : 1699089383
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERNESTO BARBOSA DMD
Provider Business Mailing Address
First Line : 721 CHEPSTOW AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178-1246
Country : US
Telephone Number : 702-278-0876
Fax Number :
Provider Business Practice Location Address
First Line : 1703 CIVIC CENTER DR STE 6
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7273
Country : US
Telephone Number : 702-649-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2010
Last Update Date : 08/05/2010

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Directions to “ DR. ERNESTO BARBOSA DMD” Practice Location

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