Organization
ANTHEM VILLAGE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WILFORD NISSON DDS (OFFICER IN CORPORATION)
(702) 454-7704
Entity
Organization
Contact information
Practice address
2571 ANTHEM VILLAGE DR, SUITE #5, HENDERSON, NV 89052-5508
(702) 454-7704
(702) 454-0200
Mailing address
2571 ANTHEM VILLAGE DR, SUITE #5, HENDERSON, NV 89052-5508
(702) 454-7704
(702) 454-0200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
132074
NV
Other
Enumeration date
01/18/2007
Last updated
08/22/2020
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