Organization
HENDERSON PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE STACEY (DR)
(303) 603-4800
Entity
Organization
Contact information
Practice address
390 N STEPHANIE ST STE 104, HENDERSON, NV 89014-8029
(720) 603-4700
Mailing address
390 N STEPHANIE ST STE 104, HENDERSON, NV 89014-8029
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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