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General NPI Number Information
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NPI Number | 1295284230
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Entity Type | Organization
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Legal Business Name | ATWOOD VEGAS FAMILY DENTAL
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Dates
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Enumeration Date | 10/03/2016
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 2840 E FLAMINGO RD SUITE G
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City | LAS VEGAS
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State | NV
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Zip | 89121-5269
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Country | US
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Telephone | 702-228-1106
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 E FLAMINGO RD SUITE G
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City | LAS VEGAS
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State | NV
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Zip | 89121-5269
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Country | US
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Telephone | 702-228-1106
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. AARON M ATWOOD
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Credential | DMD
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Telephone | 702-374-1755
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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 | 5795
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License Number State | NV
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