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Organization
DENTAL IMPLANT SPECIALISTS OF NEVADA, GOLPA PC
Active
Organization
DENTAL IMPLANT SPECIALISTS OF NEVADA, GOLPA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE GOLPA (OWNER DENTIST)
(702) 768-7840
Entity
Organization
Contact information
Practice address
6420 MEDICAL CENTER ST STE 101, LAS VEGAS, NV 89148-2402
(702) 641-7111
Mailing address
3500 MAPLE AVE STE 1600, DALLAS, TX 75219-3936
(909) 732-0191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
04/04/2023
Last updated
04/06/2023
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