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General NPI Number Information
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NPI Number | 1780819193
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Entity Type | Organization
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Legal Business Name | NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 3975 S DURANGO DR STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89147-4156
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Country | US
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Telephone | 702-254-1444
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Fax | 702-228-2236
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Provider Business Mailing Address
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Address Line | 3975 S DURANGO DR STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89147-4156
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Country | US
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Telephone | 702-254-1444
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Fax | 702-228-2236
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | CARMEN WOODS
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Credential |
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Telephone | 214-540-5100
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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 |
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License Number State |
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