# MARICONDIA DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AQ Dentures
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508282351
- **Authorized official:** KIMBERLY WHITE (FRONT DESK)
- **Authorized official phone:** (702) 565-6000

## Contact information

- **Practice address:** 349 W LAKE MEAD PKWY, HENDERSON, NV 89015
- **Practice address phone:** (702) 565-6000
- **Practice address fax:** (702) 565-0474
- **Mailing address:** 349 W LAKE MEAD PKWY, HENDERSON, NV 89015-7029
- **Mailing address phone:** (702) 565-6000
- **Mailing address fax:** (702) 565-0474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4092 | NV | Yes |

## Other

- **Enumeration date:** 03/17/2014
- **Last updated:** 05/17/2023