Individual
DR. MARLOWE ANTHONY SAN JUAN RILLERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2625 S RAINBOW BLVD STE D103, LAS VEGAS, NV 89146-5181
(702) 365-1743
Mailing address
2625 S RAINBOW BLVD STE D103, LAS VEGAS, NV 89146-5181
(702) 365-1743
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30249
TX
1223G0001X
General Practice Dentistry
Primary
7352
NV
Other
Enumeration date
08/06/2014
Last updated
07/07/2020
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