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NPI Code Detail

MEDICARE: DR. DAVID JAMES TRYLOVICH D.D.S., M.S.

MEDICARE: DR. DAVID JAMES TRYLOVICH D.D.S., M.S.
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
11223P0300XPeriodontics2707/S4-14NV

General Provider Information

NPI Number : 1396906863
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID JAMES TRYLOVICH D.D.S., M.S.
Provider Business Mailing Address
First Line : 3811 W CHARLESTON BLVD
Second Line : #201
City : LAS VEGAS
State : NV
Zip : 89102-1846
Country : US
Telephone Number : 702-259-1943
Fax Number : 702-877-2727
Provider Business Practice Location Address
First Line : 3811 W CHARLESTON BLVD
Second Line : #201
City : LAS VEGAS
State : NV
Zip : 89102-1846
Country : US
Telephone Number : 702-259-1943
Fax Number : 702-877-2727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 06/18/2008

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