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Organization

ABRAZA DENTAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WYATT STOTT DANNELS DDS (DDS)
(702) 456-0005
Entity
Organization

Contact information

Practice address
5642 S EASTERN AVE, SUITE B, LAS VEGAS, NV 89119-2375
(702) 456-0005
Mailing address
5642 S EASTERN AVE, SUITE B, LAS VEGAS, NV 89119-2375
(702) 456-0005

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6743
NV

Other

Enumeration date
06/14/2016
Last updated
06/15/2016
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