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NPI Code Detail

MEDICARE: TRYLOVICH, GIFFORD, LTD.

MEDICARE: TRYLOVICH, GIFFORD, LTD.
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
11223P0300XPeriodontics5103NV
21223P0300XPeriodontics2635NV
31223P0300XPeriodontics6507NV
41223P0300XPeriodontics2707NV

General Provider Information

NPI Number : 1619028800
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRYLOVICH, GIFFORD, LTD.
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 : OWNER
Name : DR. DAVID JAMES TRYLOVICH
Credential : D.D.S., M.S.
Telephone Number : 702-259-1943
Provider Enumeration Date : 01/15/2007
Last Update Date : 07/10/2014

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Directions to “TRYLOVICH, GIFFORD, LTD. ” Practice Location

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