Healthcare Provider Details

I. General information

NPI: 1538710348
Provider Name (Legal Business Name): ENCE ORTHODONTICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8490 S EASTERN AVE STE A
LAS VEGAS NV
89123-2806
US

IV. Provider business mailing address

8490 S EASTERN AVE STE A
LAS VEGAS NV
89123-2806
US

V. Phone/Fax

Practice location:
  • Phone: 702-260-8241
  • Fax: 702-260-8251
Mailing address:
  • Phone: 702-260-8241
  • Fax: 702-260-8251

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: MICHELLE DYAN JONES
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-260-8241