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NPI Code Detail

MEDICARE: DENTISTING, LLC

MEDICARE: DENTISTING, 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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1558527978
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTISTING, LLC
Provider Business Mailing Address
First Line : 2101 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3175
Country : US
Telephone Number : 702-522-2269
Fax Number : 702-990-8856
Provider Business Practice Location Address
First Line : 5075 E BONANZA RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110
Country : US
Telephone Number : 702-871-8888
Fax Number : 702-871-8889
Authorized Official
Title or Position : INSURANCE DEPT MANAGER
Name : ROLAND PISCHINGER
Credential :
Telephone Number : 702-522-2028
Provider Enumeration Date : 08/05/2008
Last Update Date : 05/31/2018

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Directions to “DENTISTING, LLC ” Practice Location

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