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General NPI Number Information
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NPI Number | 1043812993
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Entity Type | Organization
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Legal Business Name | DENTAL HYGIENE DIRECT
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Dates
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Enumeration Date | 11/14/2020
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Last Update Date | 11/14/2020
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Provider Practice Location Address
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Address Line | 1930 VILLAGE CENTER CIR STE 3-957
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City | LAS VEGAS
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State | NV
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Zip | 89134-6299
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Country | US
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Telephone | 702-721-8405
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Fax |
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Provider Business Mailing Address
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Address Line | 12261 LOS MARES LN
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City | LAS VEGAS
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State | NV
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Zip | 89138-1124
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Country | US
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Telephone | 714-292-3291
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Fax |
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Authorized Official
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Title or Position | PATIENT CARE DIRECTOR
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Name | JESSICA WOODS
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Credential | MPH, RDH
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Telephone | 702-721-8405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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