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NPI Code Detail

MEDICARE: ACCUCARE COSMETIC AND FAMILY DENTISTRY, INC

MEDICARE: ACCUCARE COSMETIC AND FAMILY DENTISTRY, INC
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
11223G0001XGeneral Practice Dentistry3528NV

General Provider Information

NPI Number : 1154694008
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACCUCARE COSMETIC AND FAMILY DENTISTRY, INC
Provider Business Mailing Address
First Line : 5431 S RAINBOW BLVD STE C3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1864
Country : US
Telephone Number : 702-647-6453
Fax Number : 702-873-7654
Provider Business Practice Location Address
First Line : 5431 S RAINBOW BLVD STE C3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1864
Country : US
Telephone Number : 702-647-6453
Fax Number : 702-873-7654
Authorized Official
Title or Position : OWNER
Name : DR. DAVID W. LEE
Credential : D.D.S.
Telephone Number : 702-647-6453
Provider Enumeration Date : 02/22/2012
Last Update Date : 02/22/2012

Similar Medicare Providers

1750440624 — DR. DAVID W LEE D.D.S.
Practice Location Address:
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LAS VEGAS, NV
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Practice Fax: 702-873-7654
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Directions to “ACCUCARE COSMETIC AND FAMILY DENTISTRY, INC ” Practice Location

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