# MUGLESTON HENDERSON MODERN DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Henderson Modern Dentistry and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558620823
- **Authorized official:** DR. CODY P MUGLESTON (DDS-OWNER)
- **Authorized official phone:** (702) 464-3090

## Contact information

- **Practice address:** 366 W LAKE MEAD PKWY STE 100, HENDERSON, NV 89015-7287
- **Practice address phone:** (702) 464-3090
- **Practice address fax:** (702) 464-3158
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (949) 474-1495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4908 | NV | Yes |

## Other

- **Enumeration date:** 05/08/2012
- **Last updated:** 01/15/2014