MEDICARE: DR. MON-HAN YOUNG DMD

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
1	1223G0001X	General Practice Dentistry	4507	NV

General Provider Information

NPI Number	:	1730258443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MON-HAN YOUNG DMD

Provider Business Mailing Address
First Line	:	10126 SILBURY HILL CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4727
Country	:	US
Telephone Number	:	702-252-8688
Fax Number	:

Provider Business Practice Location Address
First Line	:	4555 S FORT APACHE RD
Second Line	:	#136
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7968
Country	:	US
Telephone Number	:	702-388-8979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/07/2007

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