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General NPI Number Information
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NPI Number | 1780334755
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Entity Type | Organization
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Legal Business Name | MAHON WINEMAN COMMUNITY DENTAL SERVICES PC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 825 S. MAIN STREET
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City | TONOPAH
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State | NV
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Zip | 89049
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Country | US
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Telephone | 702-326-9461
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Fax |
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Provider Business Mailing Address
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Address Line | 2193 HORSE PRAIRIE DR
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City | HENDERSON
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State | NV
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Zip | 89052-5834
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Country | US
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Telephone | 702-242-1644
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Fax |
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Authorized Official
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Title or Position | SECERTARY
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Name | DR. JOSEPH ARMSTRONG WINEMAN
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Credential | DMD
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Telephone | 702-270-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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