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Organization
TOM GODFREY DMD PLLC
Active
Organization
TOM GODFREY DMD PLLC
Active
Other names
Lone Mountain Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GODFREY DMD (DOCTOR)
(702) 655-9533
Entity
Organization
Contact information
Practice address
4818 W LONE MOUNTAIN RD, LAS VEGAS, NV 89130-2239
(702) 655-9533
(702) 655-9565
Mailing address
4818 W LONE MOUNTAIN RD, LAS VEGAS, NV 89130-2239
(702) 655-9533
(702) 655-9565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6936
1063844710
NV
Enumeration date
01/07/2022
Last updated
01/07/2022
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