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General NPI Number Information
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NPI Number | 1407409089
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Entity Type | Individual
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Provider Name | DAVID ARMEL GOMEZ CRODDY DDS
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Gender | Male
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 3700 PECOS MCLEOD
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City | LAS VEGAS
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State | NV
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Zip | 89121-4257
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Country | US
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Telephone | 916-606-4522
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 PECOS MCLEOD STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89121-4259
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Country | US
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Telephone | 702-732-2333
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Fax | 702-732-0881
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 104117
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7331
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License Number State | NV
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