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General NPI Number Information
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NPI Number | 1952183329
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Entity Type | Organization
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Legal Business Name | NEVADA ORTHODONTICS AND PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 7550 W LAKE MEAD BLVD STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89128-1001
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Country | US
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Telephone | 702-802-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 W LAKE MEAD BLVD STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89128-1001
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Country | US
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Telephone | 702-802-0035
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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. TRAVIS NEU
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Credential | DMD
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Telephone | 702-305-2117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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