MEDICARE: CURRENT GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6329	NV

General Provider Information

NPI Number	:	1144653338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURRENT GROUP LLC

Provider Business Mailing Address
First Line	:	4205 S GRAND CANYON DR STE 19
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7152
Country	:	US
Telephone Number	:	702-257-9177
Fax Number	:

Provider Business Practice Location Address
First Line	:	4205 S GRAND CANYON DR STE 19
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7152
Country	:	US
Telephone Number	:	702-257-9177
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MICHAEL JOSEPH WILLS
Credential	:	D.M.D.
Telephone Number	:	702-257-9177

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	08/12/2013

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