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Organization

SHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS GENERAL PARTNERSHIP

Active
Other names
Shadow Creek Children's Dentistry and Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN JOLLEY (PARTNER)
(702) 701-2563
Entity
Organization

Contact information

Practice address
3410 E CENTENNIAL PKWY STE 110, NORTH LAS VEGAS, NV 89081-5627
(702) 701-2563
Mailing address
3196 S MARYLAND PKWY STE 307, LAS VEGAS, NV 89109-2314

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
06/23/2025
Last updated
06/23/2025
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