Individual
DR. NICOLE LEILA MACKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
8840 W RUSSELL RD STE 210, LAS VEGAS, NV 89148-1355
(702) 463-1300
(702) 463-4633
Mailing address
8840 W RUSSELL RD STE 210, LAS VEGAS, NV 89148-1355
(702) 463-1300
(702) 463-4633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DI024233
NJ
122300000X
Dentist
DN18071
FL
1223P0700X
Prosthodontics
055160-1
NY
1223P0700X
Prosthodontics
Primary
S543C
NV
Other
Enumeration date
09/11/2009
Last updated
09/14/2021
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