MEDICARE: DR. NADIM MORAD GUIRGUIS D.M.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	61043	CA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-267C	NV

General Provider Information

NPI Number	:	1790111672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADIM MORAD GUIRGUIS D.M.D.

Provider Business Mailing Address
First Line	:	7588 PEARL CRESCENT DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3291
Country	:	US
Telephone Number	:	702-285-2263
Fax Number	:

Provider Business Practice Location Address
First Line	:	7125 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4466
Country	:	US
Telephone Number	:	702-658-2311
Fax Number	:

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

Provider Enumeration Date	:	09/23/2013
Last Update Date	:	12/02/2014

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Directions to “ DR. NADIM MORAD GUIRGUIS D.M.D.” Practice Location

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