Healthcare Provider Details

I. General information

NPI: 1083278659
Provider Name (Legal Business Name): CELEBRACES FRANCISCO LOVELAND, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2466 E DESERT INN RD STE F
LAS VEGAS NV
89121-3622
US

IV. Provider business mailing address

2466 E DESERT INN RD STE F
LAS VEGAS NV
89121-3622
US

V. Phone/Fax

Practice location:
  • Phone: 702-674-7000
  • Fax:
Mailing address:
  • Phone: 702-674-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KELCEY LOVELAND
Title or Position: ORTHODONTIST
Credential: DMD, MS
Phone: 702-674-7000