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General NPI Number Information
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NPI Number | 1881341204
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Entity Type | Organization
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Legal Business Name | DRTHANHNGODMDPLLC
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Dates
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Enumeration Date | 03/05/2022
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 992 E SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89104-3024
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Country | US
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Telephone | 702-885-1830
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 CACTUS DESERT CT
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-3172
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Country | US
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Telephone | 702-885-1830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THANH NGO
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Credential | DMD
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Telephone | 702-885-1830
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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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