Organization
SOUTHERN NEVADA SPECIALTY PRADA, PLLC
Active
Other names
Absolute Dental & Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA PRADA DDS (OWNER)
(702) 291-2031
Entity
Organization
Contact information
Practice address
8380 W CHEYENNE AVE, #104, LAS VEGAS, NV 89129-8405
(702) 733-0888
(702) 395-8718
Mailing address
2250 S RANCHO DR, SUITE 205, LAS VEGAS, NV 89102-4451
(702) 291-2031
(702) 984-7566
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
S6-33C
NV
1223P0221X
Pediatric Dentistry
Primary
S6-33C
NV
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
S6-33C
NV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
S6-33C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275998270
—
NV
Enumeration date
12/18/2015
Last updated
01/19/2017
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