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Organization

GREATER LAS VEGAS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GRACE O MARQUEZ (OFFICE ADMINISTRATOR)
(702) 880-5858
Entity
Organization

Contact information

Practice address
8867 W FLAMINGO RD, SUITE 100, LAS VEGAS, NV 89147-8758
(702) 880-5858
Mailing address
8867 W. FLAMINGO RD., SUITE 100, LAS VEGAS, NV 89147
(702) 880-5858

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
S5 24
NV

Other

Enumeration date
12/09/2015
Last updated
12/09/2015
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