Organization
HENDERSON PEDIATRIC DENTISTRY HON DMD PC
Active
Other names
Cosmic Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDALENA EVANS (CREDENTIALING SPECIALIST)
(720) 603-4788
Entity
Organization
Contact information
Practice address
390 N STEPHANIE ST STE 104, HENDERSON, NV 89014-8029
(702) 947-7700
Mailing address
390 N STEPHANIE ST STE 104, HENDERSON, NV 89014-8029
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
10/14/2024
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