Healthcare Provider Details

I. General information

NPI: 1700817137
Provider Name (Legal Business Name): KRISTEN L. BELING, D.D.S., WILLIAM J. DOUGHERTY, D.M.D., P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 N PECOS RD SUITE B
HENDERSON NV
89074-7329
US

IV. Provider business mailing address

54 N PECOS RD SUITE B
HENDERSON NV
89074-7329
US

V. Phone/Fax

Practice location:
  • Phone: 702-436-4300
  • Fax: 702-436-0334
Mailing address:
  • Phone: 702-436-4300
  • Fax: 702-436-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM JOHN DOUGHERTY JR.
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 702-436-4300