Organization
OMFS SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDAN G JOHNSON DDS (PRESIDENT)
(702) 360-8918
Entity
Organization
Contact information
Practice address
6950 SMOKE RANCH RD, SUITE 200, LAS VEGAS, NV 89128-1300
(702) 360-8918
(702) 360-2156
Mailing address
6950 SMOKE RANCH RD, SUITE 200, LAS VEGAS, NV 89128-1300
(702) 360-8918
(702) 360-2156
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S228
NV
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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