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General NPI Number Information
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NPI Number | 1124425178
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Entity Type | Organization
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Legal Business Name | JOHN DUONG DMD LIMITED
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 2291 S FORT APACHE RD SUITE 104
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City | LAS VEGAS
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State | NV
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Zip | 89117-5895
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Country | US
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Telephone | 702-732-8800
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Fax | 702-869-5554
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Provider Business Mailing Address
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Address Line | 2291 S FORT APACHE RD SUITE 104
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City | LAS VEGAS
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State | NV
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Zip | 89117-5895
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Country | US
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Telephone | 702-732-8800
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Fax | 702-869-5554
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Authorized Official
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Title or Position | ENDODONTIST
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Name | DR. JOHN DUONG
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Credential | DMD
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Telephone | 702-732-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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