Organization
JFK ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY LORICK (CREDENTIALING SPECIALIST)
(919) 948-6787
Entity
Organization
Contact information
Practice address
7140 N DURANGO DR STE 110, LAS VEGAS, NV 89149-4473
(702) 740-8437
Mailing address
7140 N DURANGO DR STE 110, LAS VEGAS, NV 89149-4473
(702) 740-8437
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/15/2021
Last updated
04/10/2021
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