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Organization
WATANABE SHADOW MOUNTAIN DENTAL GROUP, PROFESSIONAL CORPORATION
Active
Organization
WATANABE SHADOW MOUNTAIN DENTAL GROUP, PROFESSIONAL CORPORATION
Active
Other names
SHADOW MOUNTAIN DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNDA C WATANABE DDS (OWNER DOCTOR)
(702) 577-1941
Entity
Organization
Contact information
Practice address
6525 N DECATUR BLVD, SUITE 150, LAS VEGAS, NV 89131
(702) 577-1941
(702) 395-7813
Mailing address
2860 MICHELLE, 2ND FLOOR, IRVINE, CA 92606-1009
(714) 508-3600
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/06/2007
Last updated
11/07/2007
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