# CORONA DENTAL & DENTURES, XA PROF. CORP.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Corona Dental & Dentures
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548592710
- **Authorized official:** HAI XA DMD (DENTIST)
- **Authorized official phone:** (702) 456-5100

## Contact information

- **Practice address:** 5080 E BONANZA RD, LAS VEGAS, NV 89110-3524
- **Practice address phone:** (702) 456-5100
- **Practice address fax:** (702) 456-5102
- **Mailing address:** 5080 E BONANZA RD, LAS VEGAS, NV 89110-3524
- **Mailing address phone:** (702) 456-5100
- **Mailing address fax:** (702) 456-5102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3780 | NV | Yes |

## Other

- **Enumeration date:** 02/12/2010
- **Last updated:** 02/12/2010