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General NPI Number Information
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NPI Number | 1407095409
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Entity Type | Organization
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Legal Business Name | AARON LAC DENTAL, LTD.
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 11350 SOUTHERN HIGHLANDS PKWY SUITE 100
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City | LAS VEGAS
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State | NV
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Zip | 89141-3290
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Country | US
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Telephone | 702-834-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 72 PINE BAY CT
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City | LAS VEGAS
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State | NV
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Zip | 89148-2778
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Country | US
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Telephone | 702-672-0628
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AARON V LAC
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Credential | D.M.D.
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Telephone | 702-672-0628
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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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