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General NPI Number Information
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NPI Number | 1568412153
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Entity Type | Individual
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Provider Name | DIANA GRACE TOLENTINO DDS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 8670 W CHEYENNE AVE SUITE 150
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City | LAS VEGAS
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State | NV
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Zip | 89129-7456
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Country | US
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Telephone | 702-341-1004
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Fax | 702-341-1007
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Provider Business Mailing Address
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Address Line | 8670 W CHEYENNE AVE SUITE 150
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City | LAS VEGAS
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State | NV
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Zip | 89129-7456
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Country | US
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Telephone | 702-341-1004
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Fax | 702-341-1007
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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 | 4298
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License Number State | NV
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