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General NPI Number Information
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NPI Number | 1326267451
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Entity Type | Individual
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Provider Name | BLAIR ABBOTT ISOM D.D.S., F.A.G.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 500 N. RAINBOW BLVD SUITE 315
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City | LAS VEGAS
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State | NV
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Zip | 89107-1085
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Country | US
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Telephone | 702-645-1323
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Fax | 702-645-8807
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Provider Business Mailing Address
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Address Line | 500 N RAINBOW BLVD SUITE 315
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City | LAS VEGAS
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State | NV
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Zip | 89107-1082
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Country | US
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Telephone | 702-645-1323
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Fax | 702-870-7058
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2260
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License Number State | NV
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