Individual
GUSTAVO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
9771 S EASTERN AVE STE 100, LAS VEGAS, NV 89183-6801
(702) 616-9655
Mailing address
2074 BRASSY DR, LAS VEGAS, NV 89142-2036
(702) 283-6276
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6692
NV
Other
Enumeration date
08/16/2015
Last updated
08/16/2015
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