# TENDER DENTAL BONANAZA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TENDER DENTAL MANAGEMENT, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124556741
- **Legal business name:** TENDER DENTAL MANAGEMENT, LLC
- **Authorized official:** JONG UM DDS (PRESIDENT)
- **Authorized official phone:** (860) 325-0022

## Contact information

- **Practice address:** 5001 E BONANZA RD STE 160, LAS VEGAS, NV 89110-3560
- **Practice address phone:** (860) 325-0022
- **Mailing address:** 301 COMMONS PARK S UNIT 618, STAMFORD, CT 06902-7088
- **Mailing address phone:** (860) 491-6972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6883 | NV | Yes |

## Other

- **Enumeration date:** 05/25/2017
- **Last updated:** 05/25/2017