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Organization
ADA NEVADA DENTAL LLC
Active
Organization
ADA NEVADA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY WALTER GREENWOOD DMD, PHARMD, MACSD (CLINICAL DIRECTOR)
(504) 952-0344
Entity
Organization
Contact information
Practice address
5001 E BONANZA RD STE 160, LAS VEGAS, NV 89110-3560
(702) 307-2273
(702) 307-2275
Mailing address
5001 E BONANZA RD STE 160, LAS VEGAS, NV 89110-3560
(702) 307-2273
(702) 307-2275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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