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Organization
DILETTANTE INC.
Active
Organization
DILETTANTE INC.
Active
Parent organization
RANDY HONG
Other names
Avalon Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
RANDY HONG
Authorized official
PAMELA K PROPSTER (OFFICE MANAGER)
(702) 638-1005
Entity
Organization
Contact information
Practice address
5465 SIMMONS ST, SUITE 4, NORTH LAS VEGAS, NV 89031-9000
(702) 638-1005
(702) 638-1071
Mailing address
5465 SIMMONS ST, SUITE 4, NORTH LAS VEGAS, NV 89031-9000
(702) 638-1005
(702) 638-1071
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4348
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510098
—
NV
Enumeration date
07/26/2010
Last updated
07/26/2010
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