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NPI Code Detail

MEDICARE: US DENTAL GROUP INC

MEDICARE: US DENTAL GROUP INC
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 Dentistry3518NV

General Provider Information

NPI Number : 1912163734
Entity Type Code : Organization
Provider Name (Legal Business Name) : US DENTAL GROUP INC
Provider Business Mailing Address
First Line : 4956 E TROPICANA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-6729
Country : US
Telephone Number : 702-456-7880
Fax Number : 702-456-7870
Provider Business Practice Location Address
First Line : 4956 E TROPICANA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-6729
Country : US
Telephone Number : 702-456-7880
Fax Number : 702-456-7870
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID LEE
Credential : DMD
Telephone Number : 702-241-8206
Provider Enumeration Date : 07/31/2008
Last Update Date : 08/26/2014

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Directions to “US DENTAL GROUP INC ” Practice Location

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