Individual
DR. RONALD L LEBROKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4720 BLUE DIAMOND RD, #100, LAS VEGAS, NV 89139-7661
(702) 855-0050
(702) 629-2410
Mailing address
526 S TONOPAH DR, SUITE #200, LAS VEGAS, NV 89106-4043
(702) 291-2031
(702) 366-1483
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5606
NV
1223G0001X
General Practice Dentistry
57069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336310309
—
NV
Enumeration date
03/18/2008
Last updated
06/20/2016
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