Organization
MICHAEL R WANLASS DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WANLASS DDS (PRESIDENT)
(702) 367-4412
Entity
Organization
Contact information
Practice address
2625 S RAINBOW BLVD, SUITE C-100, LAS VEGAS, NV 89146-5198
(702) 367-4412
Mailing address
2625 S RAINBOW BLVD, SUITE C-100, LAS VEGAS, NV 89146-5198
(702) 367-4412
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
2287
NV
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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