Organization
GREGG R KOLEBUCK DDS LTD
Active
Other names
Lake Sahara Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGG R KOLEBUCK DDS (DENTIST / OWNER)
(702) 838-5400
Entity
Organization
Contact information
Practice address
1811 S RAINBOW BLVD STE 202, LAS VEGAS, NV 89146-0855
(702) 838-5400
(702) 838-5031
Mailing address
1811 S RAINBOW BLVD STE 202, LAS VEGAS, NV 89146-0855
(702) 838-5400
(702) 838-5031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3337
NV
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/12/2007
Last updated
03/19/2019
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