Individual
MATTHEW L KOSCINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8380 W CHEYENNE AVE STE 102, LAS VEGAS, NV 89129-2175
(702) 388-8989
(702) 396-0075
Mailing address
2250 S RANCHO DR STE 205, LAS VEGAS, NV 89102-4456
(702) 291-2031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
PENDING
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14011993
CAQH
NV
Enumeration date
05/18/2017
Last updated
05/18/2017
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