Healthcare Provider Details

I. General information

NPI: 1083692487
Provider Name (Legal Business Name): MONT MERRILL RINGER DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5765 S FORT APACHE RD #110
LAS VEGAS NV
89148-5662
US

IV. Provider business mailing address

5765 S FORT APACHE RD #110
LAS VEGAS NV
89148-5662
US

V. Phone/Fax

Practice location:
  • Phone: 702-876-6337
  • Fax: 702-876-2988
Mailing address:
  • Phone: 702-876-6337
  • Fax: 702-876-2988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2060
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: