Organization
HENDERSON MODERN DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY MUGLESTON D.M.D. (OWNER DOCTOR)
(702) 464-3090
Entity
Organization
Contact information
Practice address
386 W LAKE MEAD PKWY, SUITE 100, HENDERSON, NV 89015-7417
(702) 464-3090
Mailing address
831 CORONADO CENTER DR, #22205, HENDERSON, NV 89052-3991
(516) 343-8731
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6650
NV
Other
Enumeration date
07/18/2015
Last updated
07/18/2015
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