MEDICARE: DR. CHRISTOPHER SPILLERS 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	261QD0000X	Dental Clinic/Center	6596	NV

General Provider Information

NPI Number	:	1902309917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER SPILLERS PLLC

Provider Business Mailing Address
First Line	:	950 S DURANGO DR STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2494
Country	:	US
Telephone Number	:	702-834-7755
Fax Number	:	702-834-7757

Provider Business Practice Location Address
First Line	:	950 S DURANGO DR STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2494
Country	:	US
Telephone Number	:	702-834-7755
Fax Number	:	702-834-7757

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER THOMAS SPILLERS
Credential	:	DMD
Telephone Number	:	702-834-7755

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	08/07/2020

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