# TRI STATE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578153276
- **Authorized official:** DR. BRIAN D NGUYEN DMD (OWNER)
- **Authorized official phone:** (702) 417-1589

## Contact information

- **Practice address:** 450 E SILVERADO RANCH BLVD STE 105, LAS VEGAS, NV 89183-6204
- **Practice address phone:** (702) 263-8820
- **Practice address fax:** (702) 914-8121
- **Mailing address:** 450 E SILVERADO RANCH BLVD STE 105, LAS VEGAS, NV 89183-6204
- **Mailing address phone:** (702) 263-8820
- **Mailing address fax:** (702) 914-8121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2021
- **Last updated:** 01/26/2021