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General NPI Number Information
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NPI Number | 1245251115
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Entity Type | Organization
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Legal Business Name | HABASHI DENTAL PC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3417 S JONES BLVD STE F
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City | LAS VEGAS
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State | NV
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Zip | 89146-6784
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Country | US
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Telephone | 702-368-5111
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Fax | 702-362-5115
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Provider Business Mailing Address
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Address Line | 3417 S JONES BLVD STE F
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City | LAS VEGAS
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State | NV
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Zip | 89146-6784
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Country | US
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Telephone | 702-368-5111
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Fax | 702-362-5115
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | AFSHIN AND TOURAJ HABASHI
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Credential | DDS
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Telephone | 702-368-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3207
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License Number State | NV
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