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General NPI Number Information
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NPI Number | 1578767836
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Entity Type | Organization
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Legal Business Name | DHANVANTARI TREHAN SALTS OF THE EARTH PC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 653 N TOWN CENTER DR SUITE # 400
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City | LAS VEGAS
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State | NV
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Zip | 89144-0514
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Country | US
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Telephone | 702-343-3522
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Fax | 702-877-3376
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Provider Business Mailing Address
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Address Line | 9811 W CHARLESTON BLVD SUITE # 2278
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City | LAS VEGAS
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State | NV
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Zip | 89117-7528
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Country | US
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Telephone | 702-343-3522
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Fax | 702-877-3376
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Authorized Official
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Title or Position | CORPORATE DESIGNEE
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Name | DR. MANJU MONIKA TREHAN
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Credential | MD
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Telephone | 702-343-3522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 11042
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License Number State | NV
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