Individual
MICHAEL GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4610 MEADOWS LN, LAS VEGAS, NV 89107-2965
(702) 878-0764
Mailing address
4610 MEADOWS LN, LAS VEGAS, NV 89107-2965
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
S3-81C
NV
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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