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General NPI Number Information
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NPI Number | 1417815689
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Entity Type | Organization
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Legal Business Name | DMA WELLNESS CENTER CORP.
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 3430 E FLAMINGO RD STE 307
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City | LAS VEGAS
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State | NV
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Zip | 89121-5066
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Country | US
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Telephone | 786-752-0846
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Fax | 702-846-4112
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Provider Business Mailing Address
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Address Line | 3430 E FLAMINGO RD STE 307
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City | LAS VEGAS
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State | NV
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Zip | 89121-5066
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Country | US
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Telephone | 786-752-0846
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Fax | 702-846-4112
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DAGMAR DE LA CRUZ
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Credential |
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Telephone | 786-752-0846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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