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General NPI Number Information
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NPI Number | 1821802448
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Entity Type | Organization
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Legal Business Name | ATLAS DENTAL LLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 4844 SPARKS BLVD STE 102
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City | SPARKS
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State | NV
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Zip | 89436-8163
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Country | US
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Telephone | 760-519-4801
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Fax |
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Provider Business Mailing Address
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Address Line | 2060 EXPERIENCE AVE UNIT 541
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City | RENO
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State | NV
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Zip | 89502-1397
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Country | US
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Telephone | 760-519-4801
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN ATLAS
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Credential | DDS
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Telephone | 760-519-4801
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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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