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General NPI Number Information
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NPI Number | 1821985383
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Entity Type | Organization
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Legal Business Name | RED ROCK DENTAL ANESTHESIA, LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 3055 SAINT ROSE PKWY UNIT 777112
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City | HENDERSON
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State | NV
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Zip | 89077-8805
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Country | US
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Telephone | 702-553-6762
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Fax | 855-655-4767
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Provider Business Mailing Address
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Address Line | 3055 SAINT ROSE PKWY UNIT 777112
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City | HENDERSON
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State | NV
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Zip | 89077-8805
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Country | US
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Telephone | 702-553-6762
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Fax | 855-655-4767
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY THEODORE ROBERTS
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Credential | DMD
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Telephone | 702-553-6762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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