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NPI Code Detail

MEDICARE: APEX ENDODONTICS OF LAS VEGAS

MEDICARE: APEX ENDODONTICS OF LAS VEGAS
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
1261QD0000XDental Clinic/CenterS7-59NV

General Provider Information

NPI Number : 1386913309
Entity Type Code : Organization
Provider Name (Legal Business Name) : APEX ENDODONTICS OF LAS VEGAS
Provider Business Mailing Address
First Line : 2337 E BONANZA RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-3418
Country : US
Telephone Number : 702-723-9808
Fax Number : 702-723-9818
Provider Business Practice Location Address
First Line : 2337 E BONANZA RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-3418
Country : US
Telephone Number : 702-723-9808
Fax Number : 702-723-9818
Authorized Official
Title or Position : ENDODONTIST
Name : DR. EDDIE TAILUNG TAI
Credential : D.M.D
Telephone Number : 702-683-6266
Provider Enumeration Date : 12/20/2011
Last Update Date : 02/14/2012

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Directions to “APEX ENDODONTICS OF LAS VEGAS ” Practice Location

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