Individual
DR. VIVEK GANDOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2212 S EASTERN AVE, LAS VEGAS, NV 89104-4124
(702) 220-9908
(702) 220-4471
Mailing address
3325 RESEARCH WAY, CARSON CITY, NV 89706-7913
(775) 888-6610
(775) 887-7046
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5625
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504768
—
NV
Enumeration date
01/31/2007
Last updated
08/14/2012
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