Individual
KYLE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2335
(702) 774-5175
(702) 774-2812
Mailing address
1700 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2335
(702) 774-5175
(702) 774-2812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LL-531-20
NV
Other
Enumeration date
03/01/2020
Last updated
08/03/2020
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