# LUXE DENTAL LLC

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

## Provider details

- **NPI number:** 1790326056
- **Authorized official:** ANTOINETTE BROEDEL (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (702) 374-1616

## Contact information

- **Practice address:** 2500 W SAHARA AVE STE 202, LAS VEGAS, NV 89102-4367
- **Practice address phone:** (702) 633-7500
- **Mailing address:** 2001 RAMROD AVE APT 2711, HENDERSON, NV 89014-2392
- **Mailing address phone:** (702) 374-1616

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2019
- **Last updated:** 10/07/2019