MEDICARE: VIRGINIA SUAREZ DMD 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	1223G0001X	General Practice Dentistry	5957	NV

General Provider Information

NPI Number	:	1962834846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA SUAREZ DMD PLLC

Provider Business Mailing Address
First Line	:	1070 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1008
Country	:	US
Telephone Number	:	702-648-3701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1070 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1008
Country	:	US
Telephone Number	:	702-648-3701
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. VIRGINIA SUAREZ
Credential	:	DMD
Telephone Number	:	201-803-4988

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	08/02/2013

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