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General NPI Number Information
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NPI Number | 1295334340
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Entity Type | Organization
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Legal Business Name | RACHEL MISMAS DDS LLC
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 7035 W ANN RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89130-3867
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Country | US
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Telephone | 702-396-2929
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Fax | 702-658-6435
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Provider Business Mailing Address
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Address Line | 7035 W ANN RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89130-3867
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Country | US
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Telephone | 702-396-2929
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Fax | 702-658-6435
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RACHEL ANNE MISMAS
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Credential | DDS
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Telephone | 323-334-6058
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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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