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Individual

RYAN WILTSIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6180 N DECATUR BLVD STE 100, LAS VEGAS, NV 89130-1505
(702) 359-3107
Mailing address
6180 N DECATUR BLVD STE 100, LAS VEGAS, NV 89130-1505

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7235
NV

Other

Enumeration date
06/26/2019
Last updated
06/26/2019
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