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General NPI Number Information
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NPI Number | 1710258116
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Entity Type | Organization
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Legal Business Name | WARM SPRINGS DENTAL OFFICE INC
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 770 E WARM SPRINGS RD STE 220
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City | LAS VEGAS
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State | NV
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Zip | 89119-4347
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Country | US
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Telephone | 702-690-4487
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Fax | 702-690-4486
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Provider Business Mailing Address
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Address Line | 770 E. WARM SPRINGS RD. STE# 220
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City | LAS VEGAS
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State | NV
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Zip | 89119-4347
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Country | US
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Telephone | 702-690-4487
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Fax | 702-690-4486
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GLENDA S YABUT
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Credential |
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Telephone | 702-690-4487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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