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General NPI Number Information
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NPI Number | 1942314182
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Entity Type | Individual
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Provider Name | NANTIYA HARNUKAL JOE D.D.S., M.S
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9155 W FLAMINGO RD 120
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City | LAS VEGAS
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State | NV
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Zip | 89147-6894
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Country | US
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Telephone | 702-838-8112
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Fax | 702-838-1907
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Provider Business Mailing Address
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Address Line | 2941 AQUALINE CT
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City | LAS VEGAS
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State | NV
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Zip | 89117-2576
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Country | US
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Telephone | 702-242-4249
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3225
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License Number State | NV
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