# SOUTH EASTERN DENTAL

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

## Provider details

- **NPI number:** 1760511091
- **Authorized official:** DR. TINA E. TIGERT D.D.S. (DENTIST)
- **Authorized official phone:** (702) 967-2536

## Contact information

- **Practice address:** 8540 S EASTERN AVE STE 120, LAS VEGAS, NV 89123-2847
- **Practice address phone:** (702) 967-2536
- **Practice address fax:** (702) 967-2538
- **Mailing address:** 8540 S EASTERN AVE STE 120, LAS VEGAS, NV 89123-2847
- **Mailing address phone:** (702) 967-2536
- **Mailing address fax:** (702) 967-2538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3329 | NV | Yes |

## Other

- **Enumeration date:** 03/04/2007
- **Last updated:** 08/22/2020