Organization
TOM GODFREY DMD PLLC
Active
Other names
Lone Mountain Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GODFREY DMD (DOCTOR)
(702) 655-9533
Entity
Organization
Contact information
Practice address
4818 W LONE MOUNTAIN RD, LAS VEGAS, NV 89130-2239
(702) 655-9533
(702) 655-9565
Mailing address
4818 W LONE MOUNTAIN RD, LAS VEGAS, NV 89130-2239
(702) 655-9533
(702) 655-9565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6936
1063844710
NV
Enumeration date
01/07/2022
Last updated
01/07/2022
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