MEDICARE: NGUYEN GATAN PLLC

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	1223E0200X	Endodontics	S7-68	NV

General Provider Information

NPI Number	:	1821423971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGUYEN GATAN PLLC

Provider Business Mailing Address
First Line	:	9550 S EASTERN AVE STE 248
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8041
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 S EASTERN AVE STE 248
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8041
Country	:	US
Telephone Number	:	702-384-0053
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	ADAM GATAN
Credential	:	DMD
Telephone Number	:	702-384-0053

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	09/09/2013

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