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Individual

AARON V LAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10170 WEST TROPICANA AVE, SUITE #155, LAS VEGAS, NV 89147
(702) 248-0081
(702) 248-7123
Mailing address
72 PINE BAY CT, LAS VEGAS, NV 89148
(702) 838-9277

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4561
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100503172
NV
01
1606724
UNITE CONCORDIA DMR
NV
Enumeration date
07/29/2006
Last updated
07/08/2007
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